Korean J Anesthesiol.
2010 Dec;59(Suppl):S191-S193. 10.4097/kjae.2010.59.S.S191.
Intraoperative acute brain swelling when performing indirect anastomosis in a patient with moyamoya disease: A case report
- Affiliations
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- 1Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Seoul, Korea.
- 2Department of Anesthesiology and Pain Medicine, Kyung Hee University, Hospital at Gangdong, Seoul, Korea. kjm@khnmc.or.kr
- KMID: 2237385
- DOI: http://doi.org/10.4097/kjae.2010.59.S.S191
Abstract
- A 6-year-old male patient who was suffering from a cold and a transient ischemic attack was scheduled to undergo encephalo-duro-arterio-synangiosis for treating his moyamoya disease. Acute brain edema occurred just after opening the dura mater. Head elevation, reduction of the head rotation and hyperventilation were done. The inhalational agents were discontinued and total intravenous anesthesia was started. The swelling was reduced after intravenously infusing mannitol. An abrupt return from hypocapnia to normocapnea during the induction of general anesthesia was thought to be the cause of the acute brain swelling. In conclusion, correction of hypocapnea needs to be performed gradually during the induction of anesthesia and when performing an operation for treating a patient with moyamoya disease.
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