Anesthesia for Emergency Craniotomy in a Patient with von Hippel Lindau Disease With Pheochromocytoma

Thoracic epidural analgesia in a patient with von Hippel‐Lindau disease

“…Of the 22 cases involving VHLD patients, 3 were pediatric patients 8‐10 and 19 were adults 1,11‐28 . There were a total of 32 surgical procedures performed among the 22 patients, including 2 cases of spontaneous labor.…”

“…Of the 22 cases involving VHLD patients, 3 were pediatric patients 8 , 9 , 10 and 19 were adults. 1 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 There were a total of 32 surgical procedures performed among the 22 patients, including 2 cases of spontaneous labor. 13 were obstetrical cases, 1 , 11 , 12 , 13 , 14 , 16 , 17 , 18 , 20 , 22 , 23 , 25 , 27 10 were neurosurgical procedures, 9 , 13 , 14 , 15 , 17 , 19 , 21 , 24 , 25 , 28 and 9 were pheochromocytoma resections.…”

“…1 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 There were a total of 32 surgical procedures performed among the 22 patients, including 2 cases of spontaneous labor. 13 were obstetrical cases, 1 , 11 , 12 , 13 , 14 , 16 , 17 , 18 , 20 , 22 , 23 , 25 , 27 10 were neurosurgical procedures, 9 , 13 , 14 , 15 , 17 , 19 , 21 , 24 , 25 , 28 and 9 were pheochromocytoma resections. 8 , 9 , 10 , 11 , 15 , 19 , 24 , 26 13 of the 22 cases reported single surgical procedures performed 1 , 8 , 10 , 12…”

“…13 were obstetrical cases, 1 , 11 , 12 , 13 , 14 , 16 , 17 , 18 , 20 , 22 , 23 , 25 , 27 10 were neurosurgical procedures, 9 , 13 , 14 , 15 , 17 , 19 , 21 , 24 , 25 , 28 and 9 were pheochromocytoma resections. 8 , 9 , 10 , 11 , 15 , 19 , 24 , 26 13 of the 22 cases reported single surgical procedures performed 1 , 8 , 10 , 12 , 16 , 18 , 20 , 21 , 22 , 23 , 26 , 27 , 28 and 9 had a combination of surgical procedures performed. 9 , 11 , 13 , 14 , 15 , 17 , 19 , 24 , 25 For the anesthetic, 10 patients had general anesthesia.…”

Craniotomy for cerebellar hemangioblastoma excision in a patient with von Hippel–Lindau disease complicated by uncontrolled hypertension due to pheochromocytoma

“…While patients’ outcomes following CNS hemangioblastoma has been generally good when atraumatic microsurgery is performed [14] , [15] , there are no clear treatment guidelines for the excision of cerebellar hemangioblastomas in patients with intracranial hypertension complicated by abnormal hypertension due to pheochromocytoma whose blood pressure is not sufficiently controlled before surgery. Goel et al used propofol, sevoflurane, and an esmolol infusion and uneventfully used labetalol (0.1 mg/kg) to control hypertension and tachycardia during emergency craniotomy in a patient with VHL and pheochromocytoma [16] . However, when catecholamines are secreted by mild abdominal compression, thereby inducing hypertension and tachycardia as seen in our case, placing a patient in the prone or sitting position for cerebellar hemangioblastoma excision appears to introduce the possibility of uncontrolled ICP and tumor bleeding due to increase in blood pressure and the potential for intraoperative death due to uncontrolled hemodynamics.…”