Persistent Hypotension and Cerebral Swelling Resulting From Mesenteric Traction Syndrome After Omental-to-Pial Pedicle Flap Transfer in a Young Woman With Refractory Moyamoya Disease: A Case Report
Autor: | Raphael H. Sacho, Paul S. Pagel, Akinwunmi Oni-Orisan, Christopher J. Roberts, Harvey J. Woehlck, Suneeta Gollapudy |
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Rok vydání: | 2017 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Vasodilation Prostacyclin Brain Edema Arterial anastomosis Surgical Flaps 03 medical and health sciences Young Adult 0302 clinical medicine 030202 anesthesiology medicine Humans Moyamoya disease Surgical treatment Pedicle flap business.industry Brain edema Disease Management 030208 emergency & critical care medicine General Medicine Traction (orthopedics) medicine.disease eye diseases Surgery surgical procedures operative Anesthesia Female Hypotension Moyamoya Disease business Omentum medicine.drug |
Zdroj: | AA case reports. 9(6) |
ISSN: | 2325-7237 |
Popis: | Superficial temporal arterial to middle cerebral arterial anastomosis is often the initial surgical treatment of Moyamoya disease. In refractory cases, placing a pedicle flap of omentum over the ischemic brain has resulted in clinical improvement or stabilization of symptoms. We present a case of persistent mesenteric traction syndrome manifested by hypotension unresponsive to conventional doses of vasopressors during and after pulling the omentum to the brain. As prostacyclin is a major mediator of hypotension from mesenteric traction syndrome and also a cerebral vasodilator, we discuss the possibility that brain swelling may be a manifestation of mesenteric traction syndrome. |
Databáze: | OpenAIRE |
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