Anaesthetic Concerns for Large Intracranial Cyst Excision: Expect the Unexpected!

Abstract

Neurosurgical procedures in infants poses various challenges such as difficulty in venous cannulation, securing invasive vascular lines, difficult airway, controlling intra-cranial tension, managing large fluid shifts to positioning- related issues and temperature maintenance. We hereby present an case of a large intracranial space occupying lesion, suspected to be a hydatid cyst, which later turned out to be an infected ventricular cyst and intraoperative problems. A thorough preparation prior to operation of infected cystic lesion of the brain is required including anticipation of massive blood loss and its management. A slow decompression of the large cystic lesion should be done.

Deep Seated Cerebral Hydatid Cyst and Its Anesthetic Considerations: A Case Report

“…The severe anaphylaxis is followed by immediate hypersensitivity reaction and increased airway pressure due to bronchospasm. The immunologic symptoms can range from mild urticaria to severe anaphylactic shock (6,(11)(12)(13). In this case, high index of suspicion and early aggressive operative treatment with intravenous epinephrine infusion along with administration of 100% oxygen and massive fluid resuscitation are necessary to minimize the life threatening risk of anaphylaxis.…”

“…Moreover, removal of large cysts leaves a cavity, which can lead to disruption of the cerebral structures and post-operative neurological complication (11). Epidural hematoma, development of subdural effusion, and pneumocephalus are among other reported complications of hydatid cyst surgery (14).…”