A 39 year old man arrived at the hospital with semi-comatose state as a result of spontaneous intracerebral hemorrhage (ICH), intraventricular hemorrhage (IVH) and subarachnoid hemorrhage (SAH). For emergency craniectomy and hematoma removal, general anesthesia with desflurane and vecuronium was planned. Before the induction of anesthesia, the body temperature and end-tidal carbon dioxide (ETCO₂) levels were 38.3℃ and 38 mmHg, respectively. The body temperature and ETCO₂ increased during surgery. After 2 hours of anesthesia, the temperature had increased to 41℃, despite bladder irrigation and body cooling. After 3 hours of anesthesia, the temperature reached 43.5℃ and cardiac arrest developed. Cardiopulmonary resuscitation was attempted, but the patient expired.