Document Detail


Intraoperative jugular bulb desaturation during acute aneurysmal rupture.
MedLine Citation:
PMID:  16371617     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To describe an episode of acute jugular venous desaturation during intraoperative rupture of a cerebral aneurysm. CLINICAL FEATURES: A 57-yr-old patient was scheduled for clipping of a large unruptured basilar tip aneurysm. Abrupt bulging of the brain was observed after bone flap removal, but before dura was opened. This was associated with concurrent development of systemic hypertension to 200/120 mmHg and jugular venous bulb (S(jv)O(2)) desaturation to 13%. Rupture of aneurysm was confirmed by frank blood in cerebrospinal fluid drainage from the lumbar subarachnoid catheter. CONCLUSIONS: Abrupt S(jv)O(2) desaturation prior to dural opening may suggest an acute increase in intracranial pressure, which in our case followed aneurysmal rupture; the systemic response to increased intracranial pressure (Cushing's response) may be ineffective in maintaining cerebral perfusion.
Authors:
Irene Rozet; David W Newell; Arthur M Lam
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  53     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-22     Completed Date:  2006-08-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  97-100     Citation Subset:  IM    
Affiliation:
Harborview Medical Center, Box 359724, 325 Ninth Avenue, Seattle, Washington 98104-2499, USA. irozet@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aneurysm, Ruptured / physiopathology*,  surgery
Cerebrovascular Circulation*
Fatal Outcome
Humans
Hypertension / etiology
Intracranial Aneurysm / physiopathology*,  surgery
Intracranial Pressure
Intraoperative Complications* / surgery
Jugular Veins / physiopathology*
Male
Middle Aged
Oxygen / blood*
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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