Abstract
Posterior fossa surgery (PFS) is one of the most complicated surgeries in the neurosurgery field. Asystole is a severe complication during this type of surgeries. Trigemino cardiac reflex (TCR) is hypothesized to stimulate the asystole. The case of a 40 year old female who established a cardiac arrest is reported when the surgeon was flooding the field with normal saline at the end of the surgery. A good knowledge of TCR is important and a close monitor should continue till the end of surgery.
Highlights
Neurosurgery is known to be one of the most challenging surgeries due to the complications that could be encountered intraoperatively and postoperatively 1
As a matter of fact, experiences and practices proved that patients are prone to asystole mainly when the surgical manipulation is near the brain stem 2, whereby trigemino cardiac reflex (TCR) is hypothesized to be the cause of the asystole
A review of parasympathetic innervation would help in comprehending the potential reasons for intraoperative asystole
Summary
Neurosurgery is known to be one of the most challenging surgeries due to the complications that could be encountered intraoperatively and postoperatively 1. Severe arrhythmias like ventricular fibrillation, supraventricular tachycardia, severe bradycardia and even asystole could be faced [1,2]. As a matter of fact, experiences and practices proved that patients are prone to asystole mainly when the surgical manipulation is near the brain stem 2, whereby trigemino cardiac reflex (TCR) is hypothesized to be the cause of the asystole. A case is represented showing an asystole that occurred during a posterior fossa surgery. Abiding by the ethical principles that stresses on respecting the patient’s privacy, the patient was contacted and she authorized a family member to be a substitute decision maker to consent publication. The substitute decision maker reviewed the case report and signed a consent form to publish the report
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