Abstract
We describe the discovery of the trigemino-cardiac reflex by Schaller in 1999 and the continued improvement of the knowledge about the trigemino-cardiac reflex involved in neurosurgery, especially in skull base surgery, during the past several years. The achieved medical progress could be gained only by the practical experience described by different case reports and later case series that have been published in several principal scientific journals. Additionally, we explain the scientific as well as clinical importance of the communication of the case reports on TCR. Special reference has been given to the validity of the case reports for new phenomena in clinical medicine.
Highlights
We describe the discovery of the trigemino-cardiac reflex by Schaller in 1999 and the continued improvement of the knowledge about the trigemino-cardiac reflex involved in neurosurgery, especially in skull base surgery, during the past several years
They are often the main source of new knowledge about rare clinical features in medicine, especially in surgery. One such example is the discovery of the trigeminocardiac reflex (TCR), a well-recognized brainstem reflex that consists of bradycardia, arterial hypotension, apnea and gastric hypermotility [1]
Clear proof of the reflex’s existence was provided on a causal relationship basis, and the TCR arc was described to be constituted of trigeminal and cardioinhibitory vagus nerves as the afferent and efferent pathways. After this initial case series that suggested for the first time a definition of the TCR based on clinical and theoretical consideration, the subsequently published case reports could focus on the differentiation between the peripheral and central stimulation [2]
Summary
We describe the discovery of the trigemino-cardiac reflex by Schaller in 1999 and the continued improvement of the knowledge about the trigemino-cardiac reflex involved in neurosurgery, especially in skull base surgery, during the past several years. After this initial case series that suggested for the first time a definition of the TCR based on clinical and theoretical consideration, the subsequently published case reports could focus on the differentiation between the peripheral and central stimulation [2]. It always represents a substantial problem to generalize from a few case reports to larger case series.
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