Skip to main content
SpringerLink
Log in

The Patient with an Intracranial Tumor

  • Chapter
Preanesthetic Assessment 2

  • 75 Accesses

Abstract

A 49-year-old right-handed man came to the hospital complaining of right-sided weakness and dysphagia. There were no sensory changes and no weight loss. He gave a long history of hypertension. Past surgical history was significant for left thoracotomy and upper lobectomy for carcinoma 1 year previously. Medications consisted of hydrochlorothiazide, dexamethasone, Cimetidine, and acetaminophen. He had no allergies and had smoked two packs of cigarettes daily for 30 years. He had continued to smoke since his surgery last year.

Physical examination revealed a well-developed male with a mild right facial palsy; blood pressure was 130/70 mmHg; pulse, 80/min; respiratory rate, 12/min; height, 5ft 8in; weight, 176 lb. Examination results for the heart and lungs were normal. Neurologic examination showed 4/5 hemiparesis, no sensory deficits, and brisk reflexes with no clonus on the right side.

Laboratory data: hematocrit, 42%; SMA-12, normal; ECG, nonspecific ST-, T-wave changes; chest x-ray, inflation of the left upper lung fields, surgical clips noted. CT scan showed a left frontal ring enhancing lesion with much surrounding edema and mass effect. He was scheduled for left frontoparietal craniotomy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Cutler RWP, Neurology, in E Rubinstein, DD Federman (eds): Scientific American Medicine. 1981;1:1–7.

    Google Scholar 

  2. Koht AH, Neurosurgical Anesthesia, in RD Dripps, JE Eckenhoff, LD Vandam (eds): Introduction to Anesthesia. Philadelphia: WB Saunders, 1982, pp 333–40.

    Google Scholar 

  3. Shapiro HM, Neurosurgical Anesthesia and Intracranial Hypertension, in RD Miller (ed): Anesthesia. New York: Churchill Livingstone, 1986, pp 1563–68.

    Google Scholar 

  4. Langfitt TW, Weinstein JD, Kassel NF, Vascular factors in head injury contribution to brainswelling and intracranial hypertension, in WF Caveness, AE Walker (eds): Head Injury Conference Proceeding. Philadelphia: Lippin-cott, 1966, pp 172–94.

    Google Scholar 

  5. Lundberg N, Crongvist K, Jallquist A, Clinical investigation on interrelations between intracranial pressure and intracranial hemodynamics, in W. Luyendijk (ed): Progress in Brain Research. Amsterdam: Elsevier, 1968, pp 69–75.

    Google Scholar 

  6. Tabaddor K. Physiology of intracranial pressure, in EAM Frost (ed): Clinical Anesthesia in Neurosurgery. Boston: Butterworth, 1984, pp 45–9.

    Google Scholar 

  7. McGraw CP. Epidural intracranial pressure monitoring, in N Lundberg, U Ponten, M Brock (eds): Intracranial Pressure, vol. 2. New York: Springer-Verlag, 1975, pp 394–96.

    Chapter  Google Scholar 

  8. Vries JK, Becker DP, Young HF. A subarachnoid screw for monitoring intracranial pressure. J Neurosurg 1973;39:416–19.

    Article  PubMed  CAS  Google Scholar 

  9. Lundberg N. Continuous recording and control of ventricular fluid pressure in neurosurgical practice. Acta Psychiatr Neurol Scand 1960;36(Suppl):149.

    Google Scholar 

  10. Marmarou A, Shulman K, LaMorgese J. Compartmental analysis of compliance and outflow resistance of the cerebrospinal fluid system. J Neurosurg 1975;43:523–34.

    Article  PubMed  CAS  Google Scholar 

  11. Grucer G, Viernstein LS, Chubuck JG, et al. Clinical evaluation of long-term epidural monitoring of intracranial pressure. Surg Neurol 1979;12:373–77.

    Google Scholar 

  12. Siesjo BK. Cerebral circulation and metabolism. J Neurosurg 1984;60:883.

    Article  PubMed  CAS  Google Scholar 

  13. Cohen PJ, Alexander SC, Smith TC, et al. Effects of hypoxia and normocapnia on cerebral blood flow and metabolism in conscious man. J Appl Physiol 1967;23:183–89.

    PubMed  CAS  Google Scholar 

  14. Kety SS, Shenkin HA, Schmidt CF. The effects of increased intracranial pressure on cerebral circulatory functions in man. J Clin Invest 1948;27: 493–99.

    Article  Google Scholar 

  15. Graf CJ, Rossi NP. Catecholamine response to intracranial hypertension. J Neurosurg 1978;49:862–68.

    Article  PubMed  CAS  Google Scholar 

  16. Sieber FE, Smith DS, Traystman RJ, Wollman H. Glucose: A reevaluation of its intraoperative use. Anesthesiology 1987;67:72–81.

    Article  PubMed  CAS  Google Scholar 

  17. Kitchens CS. Concept of hypercoagulability. A review of its development, clinical application and recent progress. Semin Thromb Hemost 1985;11: 293–315.

    Article  PubMed  CAS  Google Scholar 

  18. Sawoya R, Cummins CJ, Kornblith PL. Brain tumors and plasmin inhibitors. Neurosurgery 1984;15:795–800.

    Article  Google Scholar 

  19. Roberts HR, Adel S, Bernstein EF. Prevention of venous thrombosis and pulmonary embolism. National Institutes of Health Consensus Development Conference Statements, 1986;6(2).

    Google Scholar 

  20. Sawoya R, Donlon JA. Chronic disseminated intravascular coagulation and metastatic brain tumor: A case report and review of the literature. Neurosurgery 1983;12:580–84.

    Article  Google Scholar 

  21. Jacobs SK, Wilson DJ, Melin G, et al. Interleukin-2 lymphokine activated killer (LAK) cells in the treatment of malignant glioma: Clinical and experimental studies. Neurol Res 1986;8:81–7.

    PubMed  CAS  Google Scholar 

  22. Lotze MT, Matory YL, Etlinghausen SE. In vivo administration of purified human interleukin 2. J Immunol 1985;135:2865–75.

    PubMed  CAS  Google Scholar 

  23. Williams WT, Lowry RL, Eggers BWN. Anesthetic management during therapeutic disruption of the blood brain barrier. Anesth Analg 1986;65: 188–90.

    PubMed  CAS  Google Scholar 

  24. Edmunds-Seal J, Prys-Roberts C, Adams AP. Air embolism. A comparison of various methods of detection. Anaesthesia 1971;26:202–98.

    Article  Google Scholar 

  25. Albin NS, Babinski M, Maroon JC, et al. Anesthetic management of posterior fossa surgery in the sitting position. Acta Anaesthesiol Scand 1976;20:117–28.

    Article  Google Scholar 

  26. Murphy FL, Jr, Kennel EM, Jober DR, et al. The effects of Forane on cerebral blood flow and metabolism in man. New Drug Application, Ohio Medical Products, Madison, WI, 1975; pp 2386–95.

    Google Scholar 

  27. Smith AI, Wollman H. Cerebral blood flow and metabolism: Effects of anesthetic drugs and techniques. Anesthesiology 1972;36:378.

    Article  PubMed  CAS  Google Scholar 

  28. Isoflurane: A compendium. Madison, WI: Ohio Medical Products, 1981, p 59.

    Google Scholar 

  29. Kitahata LM, Katz JD. Tension pneumocephalus after posterior fossa craniotomy: A complication of the sitting position. Anesthesiology 1976;44:448–50.

    Article  PubMed  CAS  Google Scholar 

  30. Maxwell RE, Lang DM, French LA. The clinical effects of a synthetic glucocorticoid used for brain edema in the practice of neurosurgery, in HJ Reulin, K Schurrman (eds): Steroids and Brain Edema. Berlin: Springer-Verlag, 1972, p 219.

    Chapter  Google Scholar 

  31. Stoelting RK. Diuretics, in RK Stoelting (ed): Pharmacology and Physiology in Anesthetic Practice. Philadelphia: Lippincott, 1987, p 430.

    Google Scholar 

Download references

Authors
  1. Efrem Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, Albert Einstein College of Medicine of Yeshiva University Montefiore Medical Center, Bronx, NY, 10461, USA

    Elizabeth A. M. Frost M.D.

Rights and permissions

Reprints and permissions

Copyright information

© 1989 Birkhäuser Boston Inc.

About this chapter

Cite this chapter

Miller, E. (1989). The Patient with an Intracranial Tumor. In: Frost, E.A.M. (eds) Preanesthetic Assessment 2. Birkhäuser Boston. https://doi.org/10.1007/978-1-4684-6765-9_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-4684-6765-9_14

  • Publisher Name: Birkhäuser Boston

  • Print ISBN: 978-0-8176-3430-8

  • Online ISBN: 978-1-4684-6765-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation