Intraoperative cardiovascular collapse in an infant with Arnold‐Chiari malformation

We report a case of an infant with a diagnosis of Arnold‐Chiari malformation who developed acute cardiovascular collapse during posterior fossa decompression surgery. Haemodynamic manifestations were hypotension and bigeminy characterized by resistance to conventional resuscitation. The aetiology wa...

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Bibliographic Details
Published in:Pediatric anesthesia 1997-01, Vol.7 (2), p.163-166
Main Authors: TANAKA, MAKOTO, HARUKUNI, IZUMI, NAITO, HIROSHI
Format: Article
Language:English
Subjects:
Arnold-Chiari Malformation - surgery
Arnold‐Chiari malformation
Arrhythmias, Cardiac - etiology
Arrhythmias, Cardiac - therapy
Brain Stem
brainstem
cardiovascular complication
Cranial Fossa, Posterior - surgery
Decompression, Surgical
Female
Hemostasis, Surgical - adverse effects
Humans
Hypotension - etiology
Hypotension - therapy
Infant
Intraoperative Complications
Pressure
Resuscitation
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Description
Summary:We report a case of an infant with a diagnosis of Arnold‐Chiari malformation who developed acute cardiovascular collapse during posterior fossa decompression surgery. Haemodynamic manifestations were hypotension and bigeminy characterized by resistance to conventional resuscitation. The aetiology was considered to be due to brainstem compression exerted to control surgical bleeding from an inadvertently lacerated sinus at an unusual site, the rim of the foramen magnum. Restoration of blood pressure and disappearance of arrhythmia immediately followed removal of the brainstem compression rather than volume or pharmacological resuscitation.
ISSN:1155-5645
1460-9592
DOI:10.1046/j.1460-9592.1997.d01-50.x