Optic nerve glioma in infancy: a case report of the youngest patient in Thailand.

A 4-month-old infant came to the department of Ophthalmology, King Chulalongkorn Memorial Hospital with right eye proptosis, strabismus, and no vision. She was diagnosed as optic nerve and chiasm glioma. The subtotal removal of the tumor was performed and followed by chemotherapy, with a satisfactory result. Because of the large size of the tumor and the presenting symptoms and signs since the patient was only 2 month old, we believe that this tumor originated in the intrauterine period. To our knowledge, this reported case is the youngest patient with optic nerve and chiasm astrocytoma in Thailand.

Anesthetic management of cerebral aneurysm clipping using the deep hypothermic circulatory arrest technique: a case report.

Deep hypothermic circulatory arrest may prove advantageous during surgery of some technically difficult brain lesions. This technique was first applied in one patient with a large intracavernous aneurysm which had failed standard neurosurgical techniques. For this technique to be successful the cooperation of neurosurgeons, cardiovascular surgeons, anesthesiologists, perfusionists and nurses is essential. Techniques aimed at improving the outcome include a short period of circulatory arrest, the depth of hypothermia, barbiturate administration, coagulation management and well-controlled blood glucose levels. The total time of circulatory arrest and the thiopentone dosage were 61 minutes and 1,700 mg respectively. The lowest core temperature was 13.9 degrees C. The positive outcome supports the use of this technique in selected patients with complex intracranial vascular lesions who may not be operable by standard techniques.