Persistent Hypotension and Cerebral Swelling Resulting From Mesenteric Traction Syndrome After Omental-to-Pial Pedicle Flap Transfer in a Young Woman With Refractory Moyamoya Disease: A Case Report

A & a Case Reports
Harvey J WoehlckPaul S Pagel

Abstract

Superficial temporal arterial to middle cerebral arterial anastomosis is often the initial surgical treatment of Moyamoya disease. In refractory cases, placing a pedicle flap of omentum over the ischemic brain has resulted in clinical improvement or stabilization of symptoms. We present a case of persistent mesenteric traction syndrome manifested by hypotension unresponsive to conventional doses of vasopressors during and after pulling the omentum to the brain. As prostacyclin is a major mediator of hypotension from mesenteric traction syndrome and also a cerebral vasodilator, we discuss the possibility that brain swelling may be a manifestation of mesenteric traction syndrome.

References

Aug 1, 1992·Journal of Cardiothoracic and Vascular Anesthesia·T W LatsonR J Valentine
Sep 1, 1987·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·J A BevanR D Bevan
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Dec 1, 1984·Journal of Autonomic Pharmacology·T Skärby, K E Andersson
Sep 22, 1980·Brain Research·J PickardW Fitch
Dec 14, 2004·Journal of Clinical Anesthesia·Harvey WoehlckAnuradha Mann
Apr 4, 2006·European Journal of Pharmacology·Michael BucherJonny Hobbhahn

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Citations

Mar 11, 2021·Local and Regional Anesthesia·Rune B StrandbyLars B Svendsen

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