Successful Low Molecular Weight Heparin Treatment for the Global Alteration of Cortical Venous Drainage Developed after Intracranial Operation

Intracranial venous infarction and drainage alteration are rare clinical events developing after intracranial operation. Immediate anticoagulation has been recommended to restore the alteration of the intracranial venous drainage. However, for the venous drainage alteration or infarction developed just after intracranial operation, the bleeding tendency induced by the anticoagulation should be considered. We report a case of successfully managed cortical venous infarctions developed immediately after intracranial operation using low molecular weight heparin.

Effects of propofol on cerebrospinal fluid pressure in patients underwent intracranial operation / 医学研究生学报

Objective:To investigate the effects of propofol on cerebrospinal fluid pressure(CSFP),mean arterial pressure(MAP),cerebral perfusion pressure(CPP) and heart rate(HR)during induction of anesthesia in patients underwent intracranial operation. Methods: In 20 patients scheduled for elective craniotomy, an epidural catheter was placed into subarachanoid. Fentanyl(2 ?g/kg), intravenousl Midazolam (0.04~0.05mg/kg) and propofol (2mg/kg) were administered respectively prior to induction of anesthesia. CSFP,MAP,CPP and HR were monitored at 2min,5min after propofol administration and 2,5,10min after another supplementary dose of propofol 1mg/kg addendum during endotracheal intubation. Results: Compared with the preanesthetic baseline values, CSFP, CPP, and MAP all decreased significantly during induction(P

Desflurane Anesthesia Used in Patients undergoing Intracranial Operations / 临床麻醉学杂志

Objective: To investigate the appropriateness of desflurane anesthesia used in patients undergoing intracranial operations. Methods: Sixteen patients were scheduled for removal of supratentorial mass. A radial artery catheter and a subarachanoid catheter were placed respectively prior to induetion of anesthesia. MAP, cerebrospinal pressure (CSFP), PETCO2 and HR were monitored. Anesthesia was induced with intravenous midazolan, fentanyl, propofol and vecuronium. After endotracheal intubation, anesthesia was maintained by desfurane inhalation in a concentration of 6 % (1MAC) throughout the operation. MAP, CSFP and PETCO2 were recorded before and during induction, at 20min, 30min, 40min and 50min during desflurane inhalation. Results: Compared with the baseline data recorded before anesthesia, CSFP and MAP were decreased significantly during induction. The CSFP tended to increase at 20 min after inhalation of 6 % desflurane, but remained below the baseline till 50min. MAP was decreased following inhalation of 6 % desflurane and kept relatively stable thereafter. No significnt change in HR was noted. Conclusion:Under the condition of PETCO2 28-30mmHg, 1MAC desflurane anesthesia can be used safely without any increase in ICP in patients undergoing intracranial operations.

Surgical Experiences of the Ruptured Giant Middle Cerebral Artery Aneurysm(2 Cases)

The authors report their experiences of direct intracranial operation on 2 cases of ruptured giant middle cerebral artery aneurysm which have similar diameter size (over 2.5cm) and location (middle cerebral artery bifurcation area). On had showed subarachnoid hemorrhage at the right sylvian fissure and another had showed was operated 25 days after ictus because of generalized seizure attack and vasospasm on cerebral angiography, the latter was operated within 18 hours after ictus due to semicomatose mental state and intracerebral hematoma on the right temporal lobe. We have utilized on giant aneurysmal surgery with multiple tactics such as transient hypotension, temporary clipping, multiple clipping, puncture or incision of the aneurysmal body and removing of hematoma.