Опубликовать статью

Информационное партнерство

Инфоресурсы

Контакты

«

Vol. 12, Art. 24 (pp. 290-300)    |    mart 2011       

№ гос. регистрации: 0421100002\0024

»

Depressory cerebrocardial reaction occurred during the removal of large meningioma of anterior cranial fossa

Talanov A.B., Solovyova O.G.

1- GOU VPO "Ivanovo State Medical Academy
2- Oghuz "Ivanovo regional clinical hospital"

Brief summary

A case of cerebrocardial reaction occurred intraoperatively in 50 year-old woman is described. Patient was operated on large meningioma of anterior cranial fossa. Reaction has been presented with symptoms that are commonly arisen during the trigeminocardiac reflex. Bradycardia up to 48 beats per min., decrease of arterial pressure up to 50/0 mm of Hg, apnea and repeated emesis in postoperative period were observed. There was evident relationship between depression of hemodynamics and manipulation at the dura mater of cranial base and falx. Considerable continuance was a specific feature of observed reaction. Artificial pulmonary ventilation and cardiotonic stimulation (dopamine was used) were necessary during 15 hours after operation. Regardless vital disturbances the late postoperative course was favorable and the outcome was excellent. We supposed that changes in brainstem supply related to quick decrease of intracranial and cerebral venous pressure might interact with trigeminocardiac and other perioperative mechanisms. Structural modification of cerebral vessels induced by chronic intracranial and venous hypertension and the action of homeostatic mechanism initiated by changes in cerebral venous pressure were hypothesized.


Key words

trigeminocardiac reflex, cerebrocardiac reaction, intracranial hypertension, cerebral venous pressure, venous homeostatic mechanism, arterial pressure, hemodynamics

Reference list

1. Ananeva I.I. Metodika dooperacionnogo prognozirovaniya intraoperacionnogo razvitiya trigemino-kardialnogo refleksa y bolnih s vestibylyarnoi shvannomoi: Dis. … kand. med. nayk. – M., 2004. – 161 s.


2. Vihert T.M. Ostrie rasstroistva krovoobrasheniya pri opyholyah golovnogo mozga. V kn: Egorov B.G. (red.) Narysheniya krovoobrasheniya pri porajeniyah golovnogo mozga. M: Medgiz; 1956. – S. 132-146.


3. Kopilov M.B. Patologiya glybokih ven pri vklinenii mozga v tentorialnoe otverstie // Vopr. neirohir. – 1961. – № 4. – S. 20-23.


4. Koreisha L.A. Analiz patogeneza rasstroistv obshego i mestnogo krovoobrasheniya pri porajeniyah golovnogo mozga v klinike i eksperimente. V kn: Egorov BG (red.) Narysheniya krovoobrasheniya pri porajeniyah golovnogo mozga . M: Medgiz; 1956. – S. 96-113.


5. Talanov A.B. Biofizicheskie principi fynkcionirovaniya arteriovenoznih malformacii golovnogo mozga. Ivanovo: Pressto. 2008. 124 c.


6. Hrapov V.S. Dve sistemi regylyacii i reaktivnost serdechno-sosydistoi deyatelnosti pri ochagovih porajeniyah golovnogo mozga. Novosibirsk: Nayka. 1973. 262 c.


7. Alexander J.P. Reflex disturbances of cardiac rhythm during ophthalmic surgery. Br J Ophthalmol. – 1975. - Vol. 59. – P. 518-524.


8. Arasho B., Sandu N., Spiriev T., Prabhakar H., Schaller B. Management of the trigeminocardiac reflex: facts and own experience // Neurol India. – 2009. – Vol. 57. – P. 375-380.


9. Barnard N.A., Bainton R.. Bradycardia and the trigeminal nerve // J Craniomaxillofac Surg. – 1990. – Vol. 18. – P. 359-360.


10. Bauer D.F., Youkilis A., Schenck C., Turner C.R., Thompson B.G. The falcine trigeminocardiac reflex: case report and review of the literature // Surg Neurol. – 2005. – Vol. 63. P. 143-148.


11. Cushing H. Some experimental and clinical observations concerning states of increased intracranial pressure // Am J Med Sci. – 1902. – Vol. 124. – R. 375-400.


12. Cushing H. The blood-pressure reaction of acute cerebral compression, illustrated by cases of intracranial hemorrhage // Am J Med Sci. – 1903. – Vol. 125. – R. 1017–1045.


13. Fayon M., Gauthier M., Blanc V.F., Ahronheim G.A., Michaud J. Intraoperative cardiac arrest due to the oculocardiac reflex and subsequent death in a child with occult Epstein- Barr Virus myocarditis // Anesthesiology. – 1995. – Vol. 83. - P. 622-624.


14. Gharabaghi A., Koerbel A., Samii A., Kaminsky J., von Goesseln H., Tatagiba M., Samii M. The impact of hypotension due to the trigeminocardiac reflex on auditory function in vestibular schwannoma surgery // J Neurosurg. – 2006. – Vol. 104. P. 369-375.


15. Kato Y., Mokry M., Pucher R., Auer L.M. Cerebrovascular response to changes of cerebral venous pressure and cerebrospinal fluid pressure // Acta Neurochir (Wien). – 1991. – Vol. 109. – R. 52–56.


16. Koerbel A., Gharabaghi A., Samii A., Gerganov V., von Gösseln H., Tatagiba M., Samii M. Trigeminocardiac reflex during skull base surgery: mechanism and management // Acta Neurochir (Wien). – 2005. – Vol. 147. – P. 727-733.


17. Lang S., Lanigan D.T., van der Wal M. Trigeminocardiac reflexes: maxillary and mandibular variants of the oculocardiac reflex // Can J Anaesth. – 1991. – Vol. 38. - P. 757-760.


18. Lübbers H.T., Zweifel D., Grätz K.W., Kruse A. Classification of potential risk factors for trigeminocardiac reflex in craniomaxillofacial surgery // J Oral Maxillofac Surg. – 2010. – Vol. 68. – P. 1317-1321.


19. Lv X., Li Y., Lv M., Liu A., Zhang J., Wu Z. Trigeminocardiac reflex in embolization of intracranial dural arteriovenous fistula // AJNR Am J Neuroradiol. – 2007. – Vol. 28. – P. 1769-1770.


20. Meng Q., Yang Y., Zhou M., Li X. Trigemino-cardiac reflex: the trigeminal depressor responses during skull base surgery // Clin Neurol Neurosurg. – 2008. Vol. 110. – P. 662- 667.


21. Moonie G.T., Ress E.L., Elton D. The oculocardiac reflex during strabismus surgery // Can Anaesthet Soc J. – 1964. Vol. 11. – P. 621-632.


22. Prabhakar H., Ali Z., Rath G.P. Trigemino-cardiac reflex may be refractory to conventional management in adults // Acta Neurochir (Wien). – 2008. Vol. 150. – P. 509- 510.


23. Prabhakar H., Rath G.P., Arora R. Sudden cardiac standstill during skin flap elevation in a patient undergoing craniotomy // J Neurosurg Anesthesiol. – 2007. Vol. 19. – P. 203- 204.


24. Prabhu V.C., Bamber N.I., Shea J.F., Jellish W.S. Avoidance and management of trigeminocardiac reflex complicating awake-craniotomy // Clin Neurol Neurosurg. – 2008. – Vol. 110. - P. 1064-1067.


25. Rath G.P., Dash H.H., Prabhakar H., Pandia M.P. Cardiorespiratory arrest during trigeminal rhizolysis // Anaesthesia. – 2007. – Vol. 62. – P. 971-972.


26. Schaller B., Cornelius J.F., Prabhakar H., Koerbel A., Gnanalingham K., Sandu N., Ottaviani G., Filis A., Buchfelder M; Trigemino-Cardiac Reflex Examination Group (TCREG) // The trigemino-cardiac reflex: an update of the current knowledge. J Neurosurg Anesthesiol. – 2009. – Vol. 21. – P. 187-195.


27. Schaller B. Trigemino-cardiac reflex during transsphenoidal surgery for pituitary adenomas // Clin Neurol Neurosurg. – 2005. – Vol. 107. – P. 468-474.


28. Schaller B. Trigeminocardiac reflex. A clinical phenomenon or a new physiological entity? // J Neurol. - 2004. – Vol. 251. – P. 658-665.


29. Usami K., Kamada K., Kunii N., Tsujihara H., Yamada Y., Saito N. Transient asystole during surgery for posterior fossa meningioma caused by activation of the trigeminocardiac reflex: three case reports // Neurol Med Chir (Tokyo). – 2010. – Vol. 50. – P. 339-342.