Korean J Anesthesiol.  2016 Jun;69(3):292-295. 10.4097/kjae.2016.69.3.292.

Cardiac arrest due to intracranial hypotension following pseudohypoxic brain swelling induced by negative suction drainage in a cranioplasty patient: a case report

• Moon HS
• Lee SK
• Kim SR
• Kim SJ

• KMID: 2164857
• DOI: http://doi.org/10.4097/kjae.2016.69.3.292

Abstract

Pseudohypoxic brain swelling (PHBS) is known to be an uncommon event that may occur during and following an uneventful brain surgery, when negative suction drainage is used. The cerebrospinal fluid loss related to suction drainage can evoke intracranial hypotension that progress to PHBS. The main presentations of PHBS are sudden unexpected circulatory collapses, such as severe bradycardia, hypotension, cardiac arrest, consciousness deterioration and diffuse brain swelling as seen with brain computerized tomography (CT). We present a stuporous 22-year-old patient who underwent cranioplasty under general anesthesia. The entire course of the general anesthesia and operation progressed favorably. However, the time of scalp suture completion, sudden bradycardia and hypotension occurred, followed by cardiac arrest immediately after initiation of subgaleal and epidural suction drainage. After successful resuscitation, the comatose patient was transferred to the neurosurgical intensive care unit and PHBS was confirmed using brain CT.

Keyword

Brain swelling; Circulatory collapse; Suction drainage

MeSH Terms

Anesthesia, General
Bradycardia
Brain Edema*
Brain*
Cerebrospinal Fluid
Coma
Consciousness
Heart Arrest*
Humans
Hypotension
Intensive Care Units
Intracranial Hypotension*
Resuscitation
Scalp
Shock
Stupor
Suction*
Sutures
Young Adult