Cirsoid aneurysms (CAs) of the scalp are rare arteriovenous malformations presenting as nodular lesions of the scalp. Depending on the size and intracranial extension, they can vary from asymptomatic to potentially lethal from secondary hemorrhage. Being vascular clinically misdiagnosed cases may lead to a devastating outcome from any kind of diagnostic surgical intervention. Here, we report a case of a 45-year-old woman who presented with multiple papulonodular lesions on the scalp, diagnosed as CA.
BACKGROUND In developing country like India with limited resources we need to find ways and means of cutting the anaesthetic cost without compromising safety of patient. With the availability of various intravenous analgesics and sedatives drugs safe anaesthesia can be delivered without the use of costly volatile agents and vaporisers. METHODS 90 Adult diabetic and/or hypertensive patients were divided into three groups of 30 each. Group I patients received inj. Morphine followed by Midazolam. Group II patients received inj. Diazepam followed by Buprenorphine. Group III patients were induced with inj. Fentanyl followed by Thiopentone sodium while maintenance of anaesthesia was achieved using halothane. Hemodynamic parameters, induction and awakening time, postoperative analgesia, and cost were statistically analyzed. RESULTS Hemodynamic parameters showed no significant fluctuations and stayed within the acceptable sinus range in all three groups. Induction time was short but awakening time was longer in group III as compared to other two groups. Postoperative analgesia was longest in group II and this group was cost effective too.
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