[A patient for craniotomy with ECG abnormality occurring on admission to the operating room]

We report a 72 year old male patient for craniotomy with ECG abnormality occurring on admission to the operating room. His preoperative ECG showed normal sinus rhythm without ST-T change and T wave abnormality. On admission to the operating room, negative T wave was noted on the ECG monitor. Therefore, we applied isosorbide dinitrate tape after the induction of anesthesia. When the dura mater was opened, subarachnoid hemorrhage was noticed. Intraoperative pathological examination revealed a glioblastoma multiforme. The tumor bled from inside and outside. The perioperative T wave abnormality was probably due to subarachnoid hemorrhage or bleeding from the tumor itself. The T wave abnormality disappeared on the 10th postoperative day.