Trigeminocardiac reflex: A cause of sudden asystole during cerebellopontine angle surgery

Successful resuscitation despite prolonged cardiac arrest in a patient with undiagnosed intracranial lesion: a case report

“…16 Hemodynamic changes due to trigeminocardiac reflux (TCR) if remain persistent, may progress to ventricular arrhythmia and in some cases may be severe enough to necessitate cardiopulmonary resuscitation. 17 Regional anesthetic techniques CSE can be safely used for cesarean section in patients with intracranial space occupying lesion (ICSOL) without severe neurological deficit. 18 Lumbar puncture in patients with space occupying lesions is a well-recognized risk factor for development of transtentorial herniation.…”

Cardiac arrest after induction of anesthesia in neurosurgical patients

“…Пожалуй, наиболее изученной ситуацией, свя-занной с интраоперационной асистолией у нейро-хирургических больных (после ситуации массивной операционной кровопотери), можно считать триге-мино-кардиальный рефлекс при вмешательствах на структурах задней черепной ямки (ЗЧЯ) [11][12][13]. Однако его развитие описано и при трансназальных нейрохирургических вмешательствах на гипофизе [14,15], и при различных вариантах краниомакси-лофациальных вмешательств [16].…”

The Oculocardiac Reflex may Mimic Signs of Intracranial Hypertension in Patients with Combined Cerebral and Ocular Trauma

“…This constellation of signs, the trigeminocardiac reflex, has been observed during procedures that involve direct or indirect manipulation of the fifth cranial nerve, including craniofacial surgery, dental procedures, resection of cerebellopontine angle tumors, rhizotomy of the trigeminal ganglion or sensory root, endoscopic transphenoidal surgery, and endovascular embolization of intracranial dural arteriovenous fistulae [11][12][13][14][15][16]. Case reports describe sudden intra-operative cardiac arrest (asystole) attributable to the trigeminocardiac reflex [17,18]. The afferent limb of the reflex starts with first order sensory neurons whose cell bodies lie in the trigeminal ganglion.…”