A case requiring tracheal stenting due to superior vena cava syndrome developing after craniotomy

JA Clinical Reports
Shota SonobeMasahiko Kawaguchi

Abstract

We report a patient who developed sustained hypotension during craniotomy; further, owing to a mediastinal mass, critical tracheal stenosis and brain edema were observed after craniotomy, despite the absence of preoperative symptomatic superior vena cava (SVC) syndrome. A 62-year-old man underwent removal of a suspected metastatic brain tumor. The main brain tumor was speculated to be a metastatic tumor from lung cancer. A subsequent chest CT revealed a large solid tumor in the mediastinum. The maximum reduction in the cross-sectional area of the trachea was estimated to be 50 %. In addition, bilateral innominate veins were completely obstructed, and the superior vena cava was involved in the mass and was completely compressed. The patient did not show any cardiopulmonary symptoms or upper body edema. Intravenous lines were secured at the right extremity. General anesthesia was induced without any complications and was maintained with sevoflurane, remifentanil, and rocuronium. During the surgery, hemodynamic status fluctuated and was unstable. To maintain systolic blood pressure, continuous, massive infusion of noradrenaline was required. After the surgery, the patient was turned to the supine position. Massive facial edema was...Continue Reading

References

Jul 27, 1999·Anaesthesia·M H GohY S Goh
Jan 14, 2009·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Atilio BarbeitoJonathan B Mark
Jul 23, 2011·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Randal S Blank, Duncan G de Souza
May 5, 2012·Journal of Anaesthesiology, Clinical Pharmacology·Kapil ChaudharyPoonam Bhadoria

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