Fatal Subarachnoid Hemorrhage due to Intravascular Adrenaline Absorption

Vasoconstrictors are commonly administered with local anesthetics (LAs) to decrease intraoperative bleeding. However, inadvertent systemic absorption of adrenaline is not uncommon and is associated with significant hemodynamic consequences and arrhythmias, which are usually inconsequential. We report a case of suspected intravascular adrenaline absorption in a 1-year-old girl with craniosynostosis, which led to subarachnoid hemorrhage, herniation, and death.