Subject(s)
Hypotension/chemically induced , Nimodipine/adverse effects , Vasodilator Agents/adverse effects , Vasospasm, Intracranial/drug therapy , Aged , Angiography, Digital Subtraction , Anterior Cerebral Artery/diagnostic imaging , Blood Pressure/drug effects , Diastole/drug effects , Electrocardiography , Hemostasis, Surgical/adverse effects , Humans , Hypotension/diagnosis , Hypotension/drug therapy , Infusions, Intra-Arterial , Intracranial Aneurysm/complications , Intracranial Aneurysm/surgery , Male , Phenylephrine/administration & dosage , Subarachnoid Hemorrhage/etiology , Subarachnoid Hemorrhage/surgery , Ultrasonography, Doppler, Transcranial , Vasoconstrictor Agents/administration & dosage , Vasospasm, Intracranial/diagnosis , Vasospasm, Intracranial/etiologyABSTRACT
Hypertension in the clinical setting of posterior fossa tumors is a known entity and occurs due to medullary compression by the tumor. Such hypertension usually responds to tumor excision. Postoperative hypertension occurring after posterior fossa tumor excision has been attributed to brain stem edema in a single report earlier, which resolved without any intervention. Here, we report two pediatric patients who developed new onset refractory, persistent postoperative hypertension after medulloblastoma excision, and discuss possible causes and the prognostic significance of this condition.
ABSTRACT
A 27-year-old woman of autosomal dominant polycystic kidney disease presented with multiple intracranial aneurysms at anterior communicating artery and left middle cerebral artery bifurcation. She was undergoing hemodialysis every alternate day and was waiting for a renal transplantation. Endovascular coiling of both these aneurysms was performed under general endotracheal anesthesia. During the procedure special precaution was taken with regard to intra-procedural fluid management and maintenance of cerebral perfusion pressure. The procedure remained uneventful during which a stable hemodynamics was maintained. In this report, the implication of intraprocedural fluid infusion by the neuroradiologist its possible influence on overall anesthetic management has been described.
ABSTRACT
International Society of Blood Transfusion has recently recognized 33 blood group systems. Apart from ABO and Rhesus system, many other types of antigens have been noticed on the red cell membranes. Blood grouping and cross-matching is one of the few important tests that the anaesthesiologist orders during perioperative period. Hence, a proper understanding of the blood group system, their clinical significance, typing and cross-matching tests, and current perspective are of paramount importance to prevent transfusion-related complications. Nonetheless, the knowledge on blood group system is necessary to approach blood group-linked diseases which are still at the stage of research. This review addresses all these aspects of the blood groups system.
