One of the primary goals in Neuroanesthesia is to preserve cerebral oxygenation and protect the brain from secondary injuries. Seizures have severe implications in the intraoperative period, as it can instigate an increase in cerebral metabolism and oxygen demand, thus causing cerebral hypoxia. Detection of intraoperative seizures is imperative in neurosurgical cases as the ramifications of intracranial hypertension and cerebral hypoxia caused by it can affect patient prognosis and perioperative outcomes. We report a case of detecting intraoperative seizures with the aid of patient state index and near infrared spectroscopy. Multi-modality monitoring aided in the management of a time-sensitive complication, which could otherwise have possibly led to secondary brain insult.
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http://dx.doi.org/10.1007/s10877-020-00461-7 | DOI Listing |
Diagnostics (Basel)
November 2024
"Nicolae Oblu" Clinical Hospital, 700309 Iasi, Romania.
Arteriovenous malformations (AVMs) are complex vascular anomalies that can present with significant complications, including intracranial hemorrhage. This report presents the case of a 36-year-old female with Prothrombin G20210A mutation-associated thrombophilia, highlighting its potential impact on AVM pathophysiology and management. The patient presented with a right paramedian intraparenchymal frontal hematoma, left hemiparesis, and seizures.
View Article and Find Full Text PDFCureus
November 2024
Department of Anaesthesiology, All India Institute of Medical Sciences, Nagpur, Nagpur, IND.
Craniopharyngiomas are rare tumors arising in the suprasellar area of the brain and are more common in the pediatric age group. Due to the involvement of the hypothalamus, central diabetes insipidus (DI) is usually associated with such lesions. Patients with DI are at risk for significant electrolyte disturbances due to high urine output and the potential for sodium imbalance.
View Article and Find Full Text PDFSurg Neurol Int
November 2024
Department of Surgery, Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Background: Intraoperative neuromonitoring is an essential tool for detecting early intraoperative neurological changes during spinal surgery. Only rarely do seizures occur during transcranial motor-evoked potentials (TcMEP).
Case Description: A 44-year-old male presented with a magnetic resonance (MR)--documented L5-S1 T2-hyperintense intradural mass that heterogeneously enhanced with Gadolinium and extended through the right S1 neural foramen.
Cureus
October 2024
Anesthesiology, Unidade Local de Saúde da Região de Aveiro, Aveiro, PRT.
Tranexamic acid (TXA) is an antifibrinolytic drug widely used to reduce blood loss in major surgeries and trauma patients, thus reducing morbimortality. In recent years, clinical indications for TXA have expanded, including many off-label uses. This broad use has led to an increased incidence of reported side effects and administration errors with serious neurological and cardiovascular outcomes, such as seizures, myoclonus, and arrhythmias.
View Article and Find Full Text PDFJ Clin Neurosci
January 2025
Department of Neurosurgery, Alder Hey Children's NHS Foundation Trust, Eaton Road, L12 2AP, Liverpool, the United Kingdom of Great Britain and Northern Ireland. Electronic address:
Background: Complete resection is essential for achieving seizure freedom in children with drug-resistant epilepsy due to focal cortical dysplasia (FCD). However, identifying altered structures intraoperatively can be challenging, potentially leading to reoperations. This study assessed the impact of intraoperative MRI (iMRI).
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