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CC BY 4.0 · J Neuroanaesth Crit Care 2023; 10(03): 196-198
DOI: 10.1055/s-0043-1770778
Case Report

Anesthetic Considerations in a Patient with Large Cavernous Carotid Aneurysm

Nidhi Singh 
1   Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Sabina Regmi 
2   Department of Neurosurgery and Neurocritical Care, Lok Nayak Hospital, Assoc. Maulana Azad Medical College, New Delhi, India
,
Kiran Jangra 
3   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract

Cavernous carotid aneurysms (CCA) are a rare form of intracranial aneurysms. Patients undergoing clipping of a large unruptured CCA pose multiple anesthetic concerns including intraoperative trigeminocardiac reflex (TCR). The anesthetist's role is paramount, specifically, preprocedure anesthetic preparation, close vital monitoring, familiarity with surgical steps, provision of a relaxed brain, and meticulous control of hemodynamics. Closed-loop communication with the surgeons throughout the surgical procedure is paramount. When TCR occurs, unnecessary use of anticholinergics should be discouraged as the hemodynamic perturbations resolve with cessation of the surgical stimulus.

Keywords

cavernous - aneurysm - trigeminocardiac reflex - anesthesia


Publication History

Article published online:
04 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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