Transient brain stem ischemia following cervical spine surgery: An unusual cause of delayed recovery

Jonnavithula, Nirmala; Cherukuri, Kavya; Durga, Padmaja; Kulkarni, Dilip Kumar; Vijayasaradhi, Mudumba; Ramachandran, Gopinath

doi:10.4103/0970-9185.137290

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…With severe overdose, the response may model brain death [ 16 ]. Our patient demonstrated these signs, which at first were attributed to delayed recovery from anesthesia [ 15 ], though as the altered mental status persisted, other causes such as seizure, stroke, and hemorrhage were evaluated for and ruled out [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Intrathecal Medication From Pain Pump Caused Prolonged Alteration in Mental Status Following Decompression of Severe Spinal Stenosis

Saadeh¹,

Smith²,

Bilowus³

et al. 2022

Cureus

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Intrathecal drug delivery (IDD) has multiple indications, including chronic pain, spasticity, and spinal cord injury. Patients with an IDD device implanted who are undergoing decompressive spinal surgery may be at risk for intrathecal (IT) drug overdose in the perioperative setting. The present report describes a patient with an IDD device who underwent elective spinal surgery that was complicated by prolonged, severe alteration in mental status over several days, requiring discontinuation of his IT medications. The patient eventually returned to his neurological baseline by postoperative day 14. In the setting of severe spinal stenosis cranially in relation to an IDD device, consideration for weaning IT medications prior to elective surgery is recommended to avoid potential IT overdose. Patients undergoing weaning should be monitored for signs and symptoms of medication withdrawal.

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Section: Discussionmentioning

confidence: 99%

Intrathecal Medication From Pain Pump Caused Prolonged Alteration in Mental Status Following Decompression of Severe Spinal Stenosis

Saadeh¹,

Smith²,

Bilowus³

et al. 2022

Cureus

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show abstract

“…Outcomes vary ranging from pseudoaneurysm, reversible neurological deficit, infarction, late-onset bleeding and even death. Four cases of unrecognised brainstem ischaemia during cervical spine surgery have been reported 17–20. These all involved adult patients who underwent anterior cervical spine decompression and instrumentation surgery.…”

Section: Discussionmentioning

confidence: 99%

Narcotrend-guided intraoperative care of a Trisomy 21 paediatric patient who underwent occipitocervical fusion

Villa

Bundoc

2020

BMJ Case Rep

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A 9-year-old female with Trisomy 21 with complex craniovertebral instability causing severe cervicomedullary compression underwent occipitocervical fusion. This paper will discuss the anaesthetic management and highlight the use of the Narcotrend monitor not only as a depth of consciousness monitor but more importantly as a tool to detect surgery-induced cerebral hypoperfusion by monitoring the right and left cerebral hemispheres independently and simultaneously.

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Transient brain stem ischemia following cervical spine surgery: An unusual cause of delayed recovery

Cited by 2 publications

References 8 publications

Intrathecal Medication From Pain Pump Caused Prolonged Alteration in Mental Status Following Decompression of Severe Spinal Stenosis

Intrathecal Medication From Pain Pump Caused Prolonged Alteration in Mental Status Following Decompression of Severe Spinal Stenosis

Narcotrend-guided intraoperative care of a Trisomy 21 paediatric patient who underwent occipitocervical fusion

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