Intraoperative acute brain swelling when performing indirect anastomosis in a patient with moyamoya disease: A case report.
10.4097/kjae.2010.59.S.S191
- Author:
Ji Sung NHO
1
;
Soo Eun CHOI
;
Jae Woo YI
;
Jong Man KANG
Author Information
1. Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Brain edema;
Cerebral revascularization;
Mannitol;
Moyamoya disease
- MeSH:
Anesthesia;
Anesthesia, General;
Anesthesia, Intravenous;
Brain;
Brain Edema;
Cerebral Revascularization;
Child;
Cold Temperature;
Dura Mater;
Head;
Humans;
Hyperventilation;
Hypocapnia;
Ischemic Attack, Transient;
Male;
Mannitol;
Moyamoya Disease;
Stress, Psychological
- From:Korean Journal of Anesthesiology
2010;59(Suppl):S191-S193
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 6-year-old male patient who was suffering from a cold and a transient ischemic attack was scheduled to undergo encephalo-duro-arterio-synangiosis for treating his moyamoya disease. Acute brain edema occurred just after opening the dura mater. Head elevation, reduction of the head rotation and hyperventilation were done. The inhalational agents were discontinued and total intravenous anesthesia was started. The swelling was reduced after intravenously infusing mannitol. An abrupt return from hypocapnia to normocapnea during the induction of general anesthesia was thought to be the cause of the acute brain swelling. In conclusion, correction of hypocapnea needs to be performed gradually during the induction of anesthesia and when performing an operation for treating a patient with moyamoya disease.
