Casos raros

Ceguera post craniotomía en posición supina: ¿Improbable o ignorada?


Post-craniotomy blindness in the supine position: Unlikely or ignored?
Vahedi P, Meshkini A, Mohajernezhadfard Z, Tubbs R S.
Asian J Neurosurg [serial online] 2013 [cited 2013 Jun 9];8:36-41.

Abstrtact
Immediate visual loss following craniotomy in the supine position is a disastrous complication in neurosurgical patients. The incidence is unknown and little is known on the definite pathogenesis. Also, preventive or restorative interventions are unclear. We describe the rare case of post-craniotomy optic neuropathy and sudden visual loss after craniotomy in the supine position for an olfactory groove meningioma, discuss the possible pathophysiology and review the literature on the pathogenesis, risk factors, and outcome. Although rare, neurosurgeons, as well as neuroanesthesiologists should be aware of the possibility of this devastating complication in the high-risk group of patients.
Keywords: Craniotomy, ischemic optic neuropathy, papilledema, pathophysiology, visual loss
http://www.asianjns.org/text.asp?2013/8/1/36/110278



Mielitis transversa aguda despues de anestesia y analgesia epidural torácica: ¿Debería ser culpada la anestesia y analgesia?

Acute transverse myelitis after thoracic epidural anesthesia and analgesia: Should
anesthesia and analgesia be blamed?
Ming-Che Hsu, Ming-Hui Hung , Jin-Shing Chen, Ya-Jung Cheng
Acta Anaesthesiologica Taiwanica 51 (2013) 37e39
Abstract
A 63-year-old man developed acute transverse myelitis (ATM) with a rapid progression of sensory and motor deficits and autonomic dysfunction 2 days after chest surgery. Thoracic epidural anesthesia/analgesia (TEA) had been administered in this case. Since the temporal and spatial relationships between TEA and ATM are so close, one may easily mistake the TEA as the cause. Therefore, we discuss here the differential diagnoses for cord damage after TEA and the characteristics of ATM, and suggest that it is unlikely that TEA is the cause of ATM in this case.
http://download.journals.elsevierhealth.com/pdfs/journals/1875-4597/PIIS1875459713000246.pdf



Estenosis traqueal no esperada durante anestesia general en posición prona en distrofia muscular de Duchenne: Informe de dos casos


Unexpected tracheal narrowing during general anesthesia in the prone position of Duchenne muscular dystrophy patient -A report of two cases-
Dong Kyu Lee, Byung Gun Lim, Il-Ok Lee, Hye-Ran Oh, Sang Ho Lim, and Mi Kyoung Lee
Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, Korea
Korean J Anesthesiol 2013 May 64(5): 456-459

Unexpected tracheal narrowing was observed in a patient with Duchenne muscular dystrophy during a corrective operation for thoracolumbar scoliosis. As the operating time progressed, peak airway pressure and end-tidal CO2 increased gradually in the prone position. We found a floppy portion of the trachea using fiberoptic bronchoscopy (FB) in the prone position. We advanced a wire-reinforced tube toward the carina beyond the lesion. This allowed correction of the ventilatory abnormalities. We encountered another patient scheduled for the same operation. We performed FB in advance before the position change and observed a narrowed portion of trachea. We advanced the tracheal tube under FB beyond the pathologic portion and then moved the patient into the prone position. The operation was done successfully without any problems.
Key Words: Duchenne muscular dystrophy, Prone position, Tracheal narrowing.
http://ekja.org/Synapse/Data/PDFData/0011KJAE/kjae-64-456.pdf



Imágenes de miopatía de Duchenne

Duchenne muscular dystrophy pictures
http://www.anestesia-dolor.org/imagenes-medicas-anestesia.html





Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org