Kawano Toshiki, Matsuda Ryosuke, Ko Sungchul, Morisaki Yudai, Abe Ryuichi, Yamada Shuichi, Nakagawa Ichiro
Department of Neurosurgery, Nara Medical University, Kashihara, Japan.
Department of Anesthesiology, Nara Medical University, Kashihara, Japan.
J Neurosurg Case Lessons. 2025 Mar 31;9(13). doi: 10.3171/CASE257.
Trigeminocardiac reflex (TCR) is a vagal reflex produced by trigeminal nerve stimulation that causes bradycardia, hypotension, and, occasionally, cardiac arrest. TCR usually occurs during surgical manipulation of the posterior fossa. In this report, the authors describe an extremely rare case of TCR that developed when a burr hole was drilled on the temporal bone during surgery for an intraventricular meningioma.
The patient was referred to the authors' department after brain imaging revealed a mass lesion in the right trigone of the lateral ventricle. The surgery, which was performed using a transcortical approach via the right temporal lobe, was conducted under general anesthesia with the patient in the supine lateral position. During craniotomy, the patient experienced 17 seconds of cardiac arrest during the drilling of a burr hole in the temporal bone. TCR could not be diagnosed at that time because it occurred during the manipulation of supratentorial craniotomy with a burr hole. The operation was aborted immediately. The second surgery was performed with the patient in the lateral position, and total removal of the tumor was achieved without causing TCR.
In this report, the authors describe a rare TCR caused by supratentorial manipulation. https://thejns.org/doi/10.3171/CASE257.
三叉神经心脏反射（TCR）是一种由三叉神经刺激产生的迷走反射，可导致心动过缓、低血压，偶尔还会导致心脏骤停。TCR通常发生在后颅窝手术操作期间。在本报告中，作者描述了一例极其罕见的TCR病例，该病例发生在一例脑室内脑膜瘤手术中颞骨钻孔时。
脑成像显示右侧侧脑室三角区有占位性病变后，该患者被转诊至作者所在科室。手术采用经右侧颞叶的皮质入路，在全身麻醉下患者取仰卧侧卧位进行。开颅手术期间，在颞骨钻孔时患者经历了17秒的心脏骤停。当时无法诊断为TCR，因为它发生在使用钻孔进行幕上开颅手术操作期间。手术立即中止。第二次手术患者取侧卧位进行，肿瘤完全切除，未引发TCR。
在本报告中，作者描述了一例由幕上操作引起的罕见TCR。https://thejns.org/doi/10.3171/CASE257 。
