Air Embolism through a Ventriculoatrial Shunt during Posterior Fossa Operation: Case Report

Neurosurgery ◽  
1985 ◽  
Vol 16 (1) ◽  
pp. 83-84
Author(s):  
Daniel G. Nehls ◽  
Philip L. Carter
Keyword(s):  
Case Report ◽  
Posterior Fossa ◽  
Air Embolism ◽  
Clinical Aspects ◽  
Unusual Complication ◽  
Sitting Position ◽  
Potential Complication ◽  
Ventriculoatrial Shunt ◽  
Operation Case ◽  
Posterior Fossa Operation

Abstract An unusual complication of air embolism through a ventriculoatrial shunt occurred in a patient undergoing posterior fossa operation in the sitting position. Because ventriculoatrial shunts are uncommon, this potential complication may not be widely recognized. A case is presented and the clinical aspects are discussed. (Neurosurgery 16:83–84, 1985)

EXTENSIVE SPINAL CORD INFARCTION AFTER POSTERIOR FOSSA SURGERY IN THE SITTING POSITION: CASE REPORT

Neurosurgery ◽  
2004 ◽  
Vol 54 (6) ◽  
pp. 1512-1516 ◽  
Author(s):  
Xavier Morandi ◽  
Laurent Riffaud ◽  
Seyed F.A. Amlashi ◽  
Gilles Brassier
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Posterior Fossa ◽  
Spinal Cord Infarction ◽  
Posterior Fossa Surgery ◽  
Sitting Position

scholarly journals A case report of anaesthesia for craniotomy in sitting position

2021 ◽  
Vol 8 (4) ◽  
pp. 611-614
Author(s):  
Dinesh Suryanarayana Rao ◽  
Veena Velmurugan
Keyword(s):  
Case Report ◽  
High Risk ◽  
Air Embolism ◽  
Hemodynamic Instability ◽  
Anaesthetic Management ◽  
Sitting Position ◽  
Venous Air Embolism ◽  
Long Duration ◽  
Exact Position ◽  
Space Occupying Lesion

Tumors in the posterior fossa can be done in lateral, supine, prone, sitting and in park bench positions. Depending on the exact position of the lesion and the technical preference of the surgeon, sitting position may be preferred. Sitting position grants best possible access to deeper structures with minimal retraction. However, maintenance of anaesthesia in this position for long duration pose some serious challenges to the anaesthesiologist including high risk of venous air embolism (VAE), hemodynamic instability and respiratory disturbances. Here, we present a case report of a 36year old male diagnosed with pineal gland space occupying lesion (SOL), operated in the sitting position under general anaesthesia. We discuss about anaesthetic management and possible complications that can be encountered.

Segmental Arachnoiditis after Posterior Fossa Operation

Neurosurgery ◽  
1981 ◽  
Vol 9 (2) ◽  
pp. 183-184 ◽  
Author(s):  
Fred Epstein ◽  
Jeffrey Allen
Keyword(s):  
Case Report ◽  
Posterior Fossa ◽  
Tissue Diagnosis ◽  
Spinal Axis ◽  
The Subject ◽  
4Th Ventricle ◽  
Posterior Fossa Operation

Abstract A 16-year-old boy was noted to have an apparent intradural sacral mass 6 weeks after the excision of a 4th ventricle ependymoma. Although spinal axis radiation was considered, it was decided to make a definitive tissue diagnosis. At sacral laminectomy, only segmental arachnoiditis was found. The implications of this finding are the subject of this case report.

Air embolism associated with wounds from a pin-type head-holder

1982 ◽  
Vol 57 (5) ◽  
pp. 710-713 ◽  
Author(s):  
Dachling Pang
Keyword(s):  
Posterior Fossa ◽  
Air Embolism ◽  
Posterior Fossa Surgery ◽  
Sitting Position ◽  
Entry Site ◽  
Content Type ◽  
Tension Pneumocephalus ◽  
Head Holder ◽  
Scalp Laceration ◽  
Fine Print

✓ A case of intraoperative air embolism during posterior fossa surgery performed with the patient in the sitting position is reported. The entry site was through a comminuted fracture and scalp laceration resulting from faulty application of a pin-type head-holder. The possible role played by a large tension pneumocephalus in the ingress of venous air is also discussed. Simple precautions regarding the use of the pin-type head-holder are suggested to lessen the possibility of air embolism through the puncture wounds.

Supratentorial Intracerebral Hemorrhage after Posterior Fossa Operation

Neurosurgery ◽  
1986 ◽  
Vol 18 (4) ◽  
pp. 472-474 ◽  
Author(s):  
Rolf W. Seiler ◽  
Heinz R. Zurbrügg
Keyword(s):  
White Matter ◽  
Intracerebral Hemorrhage ◽  
Posterior Fossa ◽  
Subcortical White Matter ◽  
Sitting Position ◽  
Possible Cause ◽  
Posterior Fossa Operation

Abstract OBJECTIVE Three cases of supratentorial intracerebral hemorrhage after posterior fossa operation are described, and nine other cases reported in the literature are reviewed. The possible causes are discussed, but in eight cases no definite cause could be found. All eight patients were operated on in the sitting position, and all had hematomas in the subcortical white matter. A possible cause might be changes in intracranial dynamics in the sitting position with disruption of subcortical veins. Other authors mention the possibility of occlusion of carotid or vertebral vessels in the neck by improper positioning of the head leading to intraoperative infarction and to hemorrhage within the infarcted brain after repositioning of the patient. With the patient in a lateral or semilateral position, this complication should be preventable.

Subdural tension pneumocephalos

1979 ◽  
Vol 50 (4) ◽  
pp. 525-527 ◽  
Author(s):  
L. Dade Lunsford ◽  
Joseph C. Maroon ◽  
Peter E. Sheptak ◽  
Maurice S. Albin
Keyword(s):  
Posterior Fossa ◽  
Air Bubbles ◽  
Posterior Fossa Surgery ◽  
Sitting Position ◽  
Twist Drill ◽  
Potential Complication ◽  
Content Type ◽  
Tension Pneumocephalus ◽  
Prompt Diagnosis ◽  
Fine Print

✓ Two patients developed subdural tension pneumocephalus after undergoing posterior fossa surgery performed in the sitting position. The mechanism for entry of air into the intracranial compartment is analogous to the entry of air into an inverted soda-pop bottle. As the fluid pours out, air bubbles to the top of the container. We have thus referred to this as the “inverted pop-bottle syndrome.” Computerized tomography provided prompt diagnosis and confirmed brain displacement. Twist-drill aspiration of the air resulted in improvement in both patients, although one patient subsequently died from an intracerebellar hemorrhage. Tension pneumocephalus appears to be another potential complication of posterior fossa surgery in the sitting position. This condition is easily diagnosed and treated, and should be considered whenever a patient fails to recover as expected following posterior fossa surgery.

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