Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-10T14:25:07.926Z Has data issue: false hasContentIssue false

Case 25 - Postoperativenormal perfusion pressure breakthrough

from Section I - Neuroanesthesia

Published online by Cambridge University Press:  03 May 2011

By
Juan P. Cata  and
Andrea Kurz
Edited by
George A. Mashour  and
Ehab Farag
George A. Mashour
Affiliation:
University of Michigan
Ehab Farag
Affiliation:
Cleveland Clinic
Get access

Summary

Normal perfusion pressure breakthrough is a potentially catastrophic event after arteriovenous malformation (AVM) surgery. Anesthesia providers should strive for tight perioperative blood pressure control and should be vigilant for signs of postoperative neurologic deterioration. This chapter presents a case study of a 37-year-old female with a 2-month history of generalized tonic-clonic seizures. The patient underwent a successful left craniotomy for clipping and resection of an AVM located in the left parietooccipital lobe. Emergent computed tomography (CT) scan of the brain showed massive cerebral edema, as well as enlarged vascular enhancement suggesting hyperperfusion and a small intracerebral hemorrhage. One month after surgery, examination demonstrated no neurologic deficit and a cerebral angiography showed normalization of flows and diameter of the left posterior cerebral artery. Neuroimaging evidence of normal pattern of cerebral vasoreactivity along with neurologic status improvement may warrant barbiturate withdrawal and careful liberalization of the blood pressure control.

Keywords

antiplatelet therapycoronary artery stentneuroanesthesiastent thrombosisperioperative managementneurosurgical patients
Type
Chapter
Information
Case Studies in Neuroanesthesia and Neurocritical Care , pp. 83 - 84
Publisher: Cambridge University Press
Print publication year: 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×