矢状窦旁后位脑膜瘤切除术中罕见的三叉神经心脏反射表现。
A rare appearance of the trigeminocardiac reflex during resection of posterior parasagittal meningioma.
作者信息
Recinos Miguel A, Hsieh Jason, Mithaiwala Hussain, Mucci Joti Juneja, Recinos Pablo F
机构信息
Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio, United States.
Department of Neurological Surgery Cleveland Clinic, Cleveland, Ohio, United States.
出版信息
Surg Neurol Int. 2021 Apr 26;12:183. doi: 10.25259/SNI_737_2020. eCollection 2021.
BACKGROUND
Although a well-recognized phenomenon of the tentorium and posterior fossa, the trigeminocardiac reflex (TCR) has been rarely reported during surgery involving the posterior falx cerebri.
CASE DESCRIPTION
We present the case of a 63-year-old woman who underwent repeat resection of an atypical parasagittal meningioma involving the posterior falx. During resection, TCR was repeatedly elicited during manipulation and coagulation of the falx. Air embolism and cardiac etiologies were initially considered while TCR was not suspected, given the location. Ultimately, TCR was recognized when asystole self-resolved upon cessation of stimulus and due to its reproducibility.
CONCLUSION
Awareness by the anesthesiologist and neurosurgeon of the possibility of TCR during falcine procedures can help with rapid identification to avoid a potentially catastrophic outcome.
背景
尽管小脑幕和后颅窝存在一种已被充分认识的现象——三叉神经心脏反射（TCR），但在涉及大脑镰后部的手术中，该反射很少被报道。
病例描述
我们报告一例63岁女性，她接受了累及大脑镰后部的非典型矢状窦旁脑膜瘤的再次切除术。在切除过程中，在大脑镰的操作和凝血过程中反复诱发了TCR。由于其位置关系，最初考虑为空气栓塞和心脏病因，而未怀疑TCR。最终，当停止刺激后心搏停止自行缓解且具有可重复性时，才识别出TCR。
结论
麻醉医生和神经外科医生了解大脑镰手术期间TCR发生的可能性，有助于快速识别，以避免潜在的灾难性后果。
Zotero 插件