Venous Air Embolism After Craniotomy Closure: Tension Pneumocephalus Implicated
| Autor: | William O. Bell, Michael A. Olympio |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Venous air embolism Veins medicine Foramen Embolism Air Humans Saline Craniotomy Third ventricle business.industry Surgery Prone position Tension pneumocephalus Anesthesiology and Pain Medicine medicine.anatomical_structure Ventricle Child Preschool Anesthesia Pneumocephalus Female Neurology (clinical) business |
| Zdroj: | Journal of Neurosurgical Anesthesiology. 6:35-39 |
| ISSN: | 0898-4921 |
| Popis: | The authors present a case of venous air embolism occurring immediately upon skin closure after craniotomy in the prone position. This 5-year-old patient had a third ventricle tumor resected with bipolar cautery via a frontal trans-collosal approach into the lateral ventricle and through the foramen of Monroe. Doppler monitoring was utilized during the case since the patient's head was extended upwards in 10 degrees reverse Trendelenburg position. No air was detected during the operation. The ventricles were filled with saline presumably displacing air, prior to dural closure. However, with an increase in nitrous oxide from 55 to 68% prior to skin closure, venous air embolism was subsequently detected by Doppler and confirmed by end-tidal/arterial pCO2 gradient. The authors speculate that tension pneumocephalus caused the venous air embolism and describe the probable route of entry into the venous system. |
| Databáze: | OpenAIRE |
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