11 Dealing with Major Vascular Injuries During Endonasal Posterior Fossa Surgery

2022 ◽  
Neurosurgery ◽  
2004 ◽  
Vol 54 (6) ◽  
pp. 1512-1516 ◽  
Author(s):  
Xavier Morandi ◽  
Laurent Riffaud ◽  
Seyed F.A. Amlashi ◽  
Gilles Brassier

1998 ◽  
Vol 14 (3) ◽  
pp. 114-119 ◽  
Author(s):  
A. Germanò ◽  
Sergio Baldari ◽  
Gerardo Caruso ◽  
Mariella Caffo ◽  
Gaspare Montemagno ◽  
...  

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Chaoliang Tang ◽  
Xiaoqing Chai ◽  
Fang Kang ◽  
Xiang Huang ◽  
Tao Hou ◽  
...  

Background. The adverse events induced by intubation and extubation may cause intracranial hemorrhage and increase of intracranial pressure, especially in posterior fossa surgery patients. In this study, we proposed that I-gel combined with tracheal intubation could reduce the stress response of posterior fossa surgery patients.Methods. Sixty-six posterior fossa surgery patients were randomly allocated to receive either tracheal tube intubation (Group TT) or I-gel facilitated endotracheal tube intubation (Group TI). Hemodynamic and respiratory variables, stress and inflammatory response, oxidative stress, anesthesia recovery parameters, and adverse events during emergence were compared.Results. Mean arterial pressure and heart rate were lower in Group TI during intubation and extubation (P<0.05versus Group TT). Respiratory variables including peak airway pressure and end-tidal carbon dioxide tension were similar intraoperative, while plasmaβ-endorphin, cortisol, interleukin-6, tumor necrosis factor-alpha, malondialdehyde concentrations, and blood glucose were significantly lower in Group TI during emergence relative to Group TT. Postoperative bucking and serious hypertensions were seen in Group TT but not in Group TI.Conclusion. Utilization of I-gel combined with endotracheal tube in posterior fossa surgery patients is safe which can yield more stable hemodynamic profile during intubation and emergence and lower inflammatory and oxidative response, leading to uneventful recovery.


1999 ◽  
Vol 13 (4) ◽  
pp. 557-573
Author(s):  
G.Stuart Ingram ◽  
Craig Goldsack

1989 ◽  
Vol 71 (5) ◽  
pp. 660-663 ◽  
Author(s):  
Stephen M. Rupp ◽  
James K. Wickersham ◽  
Ira J. Rampil ◽  
Charles B. Wilson ◽  
Judith H. Donegan

2018 ◽  
Vol 17 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Alberto Feletti ◽  
Riccardo Stanzani ◽  
Matteo Alicandri-Ciufelli ◽  
Giuliano Giliberto ◽  
Matteo Martinoni ◽  
...  

AbstractBACKGROUNDDuring surgery in the posterior fossa in the prone position, blood can sometimes fill the surgical field, due both to the less efficient venous drainage compared to the sitting position and the horizontally positioned surgical field itself. In some cases, blood clots can wedge into the cerebral aqueduct and the third ventricle, and potentially cause acute hydrocephalus during the postoperative course.OBJECTIVETo illustrate a technique that can be used in these cases: the use of a flexible scope introduced through the opened roof of the fourth ventricle with a freehand technique allows the navigation of the fourth ventricle, the cerebral aqueduct, and the third ventricle in order to explore the cerebrospinal fluid pathways and eventually aspirate blood clots and surgical debris.METHODSWe report on one patient affected by an ependymoma of the fourth ventricle, for whom we used a flexible neuroendoscope to explore and clear blood clots from the cerebral aqueduct and the third ventricle after the resection of the tumor in the prone position. Blood is aspirated with a syringe using the working channel of the scope as a sucker.RESULTSA large blood clot that was lying on the roof of the third ventricle was aspirated, setting the ventricle completely free. Other clots were aspirated from the right foramen of Monro and from the optic recess.CONCLUSIONWe describe this novel technique, which represents a safe and efficient way to clear the surgical field at the end of posterior fossa surgery in the prone position. The unusual endoscopic visual perspective and instrument maneuvers are easily handled with proper neuroendoscopic training.


2012 ◽  
Vol 7 (2) ◽  
pp. 87 ◽  
Author(s):  
GirijaPrasad Rath ◽  
Charu Mahajan ◽  
M Sujatha ◽  
SachidanandJee Bharti ◽  
Nidhi Gupta ◽  
...  

1998 ◽  
Vol 7 (9) ◽  
pp. 591-595
Author(s):  
Toshihiro Ishibashi ◽  
Hiroyasu Nagahima ◽  
Kohichi Takahashi ◽  
Saroshi Sawauchi ◽  
Shigeyuki Murakami ◽  
...  

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