Abstract
A 75-year-old woman with a history of a large subfrontal lobe meningioma and new-onset seizure disorder was admitted for surgical resection of the lesion. Past medical history was significant for obesity, questionable history of congestive heart failure (CHF) without known myocardial infarction, and hypertension. Medications on admission included phenytoin 300 mg b.i.d., propranolol 20 mg t.i.d., and hydrochlorothiazide 50 mg q.d.
The patient underwent an uneventful bifrontal craniotomy with complete resection of the meningioma. Her postoperative course was complicated by evidence of worsening CHF with subjective dyspnea, bibasilar râles, increased vascular pattern on chest x-ray, and PaO2 of 55 mmHg on room air. The patient had also developed a persistent cerebrospinal fluid rhinorrhea that did not respond to lumbar draining. A head CT scan demonstrated enlarged ventricles and edema in the area of tumor resection. A diagnosis of communicating hydrocephalus was made, and the patient was scheduled for insertion of ventriculoperitoneal shunt.
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References
Milhorat TH: Hydrocephalus and the Cerebrospinal Fluid. Baltimore, Williams and Wilkins Co, 1972; p 50.
Bull JWD: The volume of the cerebral ventricles. Neurology 1961;11:1–9.
Hakin S, Adams RD: The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics. J Neurol Sci 1965;2:307–12.
Polley M: Formation of cerebrospinal fluid. J Neurosurg 1975;42:665–73.
Corey ME, Vela AR: Effects of systemic hypotension on the rate of cerebrospinal fluid formation in dogs. J Neurosurg 1974;41:350–55.
Tripathi R: Tracing the bulk outflow route of cerebrospinal fluid by transmission and scanning electron microscopy. Brain Res 1974;80:503–6.
Milhorat TH, Hammock MK, Davis DA, Fenstermacher JD: Choroid plexus papilloma: Part 1. Proof of cerebrospinal fluid overproduction. Childs Brain 1975;2:273–81.
Milhorat TH: Hydrocephalus and the cerebrospinal fluid. Baltimore, Williams and Wilkins Co, 1972; p 48.
Kim CS, Bennett DR, Roberts TS: Primary amenorrhea secondary to noncommunicating hydrocephalus. Neurology 1969;19:533–35.
Myer JS, Kitagawa Y, Tanahashi N, et al: Pathogenesis of normal pressure hydrocephalus. Preliminary observations. Surg Neurol 1985;23:121–33.
Milhorat TH: Hydrocephalus: Pathophysiology and clinical features, in Wilkins RH, Rengachary SS (eds): Neurosurgery. New York, McGraw-Hill, 1985;p 2138.
Epstein F, Hochwald GM, Ransoff J: Neonatal hydrocephalus treated by compressive head wrapping. Lancet 1973;1:634–36.
Rubin RC, Henderson ES, Ommaya LK, et al: The production of cerebrospinal fluid in man and its modification by acetazolamide. J Neurosurg 1966;25:430–36.
Arancibia CU, Shapiro K: Pediatric neurologic surgery in clinical anesthesia, in Frost E (ed) Neurosurgery. Boston, Butterworth, 1984; pp 235–64.
Campkin TV, Turner JM, Beasley J: Neurosurgical Anaesthesia and Intensive Care. London: Butterworths, 1980; p 56.
Naidich TP, Epstein F, Lin FP, et al: Evaluation of pediatric hydrocephalus by computed tomography. Radiology 1976;119:337–45.
Cote CJ, Goldstein EA, Cote MA, et al: A single-blind study of pulse oximetery in children. Anesthesiology 1988;68:184–88.
Conrady PA, Goodman LR, Lainge F: Alterations of endotracheal tube position. Flexion and extension of neck. Crit Care Med 1976;4:8–12.
Gardner AE, Olson BL, Lichtiger M: Cerebrospinal fluid pressure during dissociative anesthesia with ketamine. Anesthesiology 1971;35:226–28.
Rosa G, Sanfilippo M, Vilardi V, et al: Effects of vecuronium bromide on intracranial pressure and cerebral perfusion pressure. Br J Anaesth 1986;58:437–43.
Minton MM, Grosslight K, Stirt JA, Bedford RF: Increases in intracranial pressure from succinylcholine: Prevention by prior nondepolarizing blockade. Anesthesiology 1986;65:165–69.
Shapiro HM, Calindo M, Wyte SR, Harris AB: Rapid intraoperative reduction of intracranial pressure with thiopentone. Br J Anaesth 1973;45:1057–62.
Goresky GV, Steward DJ: Rectal methohexital for induction of anaesthesia in children. Can Anaesth Soc J 1979;26:213–15.
Hendrichsen H, Jorgensen PB: The effects of nitrous oxide on intracranial pressure in patients with intracranial disorders. Br J Anaesth 1973;45:486–92.
Frost EAM: Is isoflurane best for the cerebral circulation? Mt Sinai J Med (NY) 1987;54:283–89.
Artu AA, Nugent M, Michenfelder JD: Enflurane causes a prolonged and reversible increase in the rate of CSF production in the dog. Anesthesiology 1982;57:255–60.
Leech P, Barker J, Fitch W: Changes in intracranial pressure and systemic arterial pressure during the termination of anaesthesia. Br J Anaesth 1974;46:315–16.
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© 1989 Birkhäuser Boston Inc.
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Malley, R.A. (1989). The Patient with Hydrocephalus. In: Frost, E.A.M. (eds) Preanesthetic Assessment 2. Birkhäuser Boston. https://doi.org/10.1007/978-1-4684-6765-9_17
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DOI: https://doi.org/10.1007/978-1-4684-6765-9_17
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