INTRODUCTION: Mild therapeutic hypothermia is an increasingly recognised treatment option to reduce perihemorrhagic edema in severe intracerebral hemorrhage.

CASE DESCRIPTION: We report the case of a 77-year old woman with atypical intracerebral hemorrhage that was treated with mild hypothermia in addition to osmotic therapy. The patient's urine subsequently showed a green discoloration. Urine discoloration was completely reversible upon discontinuation of propofol.

DISCUSSION AND EVALUATION: Propofol-related urine discoloration may have been provoked by hypothermia. Due to the benign nature of this side effect, propofol should be stopped and gastrointestinal function should be supported.

CONCLUSION: More studies are needed to show a causal role of hypothermia and related decreased enzymatic function.