Abstract
The trigemino-cardiac reflex (TCR) is a brainstem reflex that manifests as adverse cardiorespiratory events upon the stimulation of sensory branches of the fifth cranial nerve. This reflex is mainly investigated in different neurosurgical procedures and intervention. This reflex is commonly considered as an acute and mild physiological response. On the other hand, more devastating and chronic nature of this reflex is largely underreported and unknown. Therefore, this article aims to provide the comprehensive understanding of the chronic form of TCR, its manifestations, and management by literature search. Also, this paper would certainly impart a better diagnosis and understanding of TCR phenomenon by knowing the relatively less common form of a chronic TCR. This will help thousands and thousands of patients who are still in the phase of diagnosis and are suffering from vague symptoms related to this reflex.
Highlights
The trigemino-cardiac reflex (TCR) is a well-established neurogenic reflex that is mainly investigated in neurosurgical patients [1,2,3,4,5,6]
The TCR phenomenon reported in the literature mainly reveals the acute as well as transient nature of this reflex that is considered as a mild physiological response in most of the cases [3, 6]
This article aims to provide the comprehensive understanding of the chronic form of TCR, its manifestations, and management by literature search
Summary
The trigemino-cardiac reflex (TCR) is a well-established neurogenic reflex that is mainly investigated in neurosurgical patients [1,2,3,4,5,6]. The general management of such situations is the removal of stimuli [3, 6, 7] This relatively high prevalence of detection of the TCR occurrences and the relatively often benign course of the phenomenon is owing to the pre-, peri-, and postoperative presence of the anesthetists [1,2,3,4,5,6,7,8,9]. The chronic nature of TCR event is largely underestimated and underreported in the current literature This may be partly due to the persistent yet vague nature of symptoms (opposite to the acute TCR episode) that make the diagnosis very difficult.
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