A 5-Year-Old With a History of “Feeling Walls” and Nocturia for Resection of a Suprasellar Tumor

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OPEN ACCESSMay 7, 2013A 5-Year-Old With a History of “Feeling Walls” and Nocturia for Resection of a Suprasellar Tumor Kirk Lalwani, MD, Brook L. Nightwalker, MD Kirk Lalwani, MD Oregon Health & Science University School of Medicine Google Scholar More articles by this author , Brook L. Nightwalker, MD Oregon Health & Science University School of Medicine Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.9411 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractAbstract Introduction: This narrative problem-based learning module is designed to facilitate group discussion with the integration of clinical knowledge and self-directed learning. It addresses a complex situation involving a child with a suprasellar mass requiring imaging and surgical resection. It also addresses the issue of delayed emergence following neurosurgery, as well as the differential diagnosis of postoperative hyponatremia, which is common in these settings and often presents a diagnostic dilemma. Methods: After a case presentation, the instructor guides the group through a series of questions, each of which promotes discussion and reviews the available data on the subject. The module is formatted as one 2-hour session, but it can also be implemented as two 1-hour sessions, depending on time available. The module was developed based on the authors' personal experience with a similar situation and a subsequent literature search on the issues covered in the module. Selected references were added to the bibliography to enhance the learner experience and highlight current evidence to support the management options presented in the discussion. Results: This module was developed for use at the 2006 and 2008 American Society of Anesthesiologists Annual Meetings and was presented twice to learners (residents, anesthesiology faculty in academic practices, and private practice anesthesiologists) at each meeting. It was also utilized with pediatric anesthesiology fellows at the primary author's institution. The module received positive feedback from both conference attendees and pediatric anesthesiology fellows. Discussion: The module can easily be incorporated into a residency, fellowship, or CME curriculum. Although the module features a pediatric patient, many adult providers care for teenage patients and would be able to actively participate in the discussion and be engaged with the clinical issues. Educational Objectives By the end of this module, learners will be able to: Discuss the safe conduct of sedation for MRI in a pediatric patient with a brain tumor.Review the pathophysiology and clinical presentation of suprasellar tumors.Discuss the preoperative considerations for resection of a craniopharyngioma in a child.Discuss the differential diagnosis of delayed emergence following the resection of a craniopharyngioma.Discuss the diagnosis and management of postoperative hyponatremia in neurosurgical patients. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Case Stem with Model Discussion.docx Case Stem with Questions.docx Instructor's Guide.docx To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. Copyright & Permissions© 2013 Lalwani and Nightwalker. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike license.KeywordsCerebral Salt Wasting SyndromeCraniopharyngiomaHyponatremiaSedationDiabetes InsipidusComplicationsAnesthesiaMRIMagnetic Resonance Imaging Disclosures None to report. Funding/Support None to report. Prior Presentations A 5-Year Old Girl With a History of Feeling Walls and Nocturia. Problem-based learning discussion at: American Society of Anesthesiology Annual Scientific Meeting; 2006; Chicago, Illinois. A 5-Year Old Girl With a History of Feeling Walls and Nocturia for Resection of a Craniopharyngioma. Problem-based learning discussion at: American Society of Anesthesiology Annual Scientific Meeting; October 2008; Orlando, Florida. Loading ...