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Case Reports
. 2012 Apr;7(2):87-9.
doi: 10.4103/1793-5482.98654.

Asystole during posterior fossa surgery: Report of two cases

Keshav Goyal  1 , Frenny Ann Philip, Girija Prasad Rath, Charu Mahajan, M Sujatha, Sachidanand Jee Bharti, Nidhi Gupta
Affiliations
Case Reports

Asystole during posterior fossa surgery: Report of two cases

Keshav Goyal et al. Asian J Neurosurg. 2012 Apr.

Abstract

Asystole during posterior fossa neurosurgical procedures is not uncommon. Various causes have been implicated, especially when surgical manipulation is carried out in the vicinity of the brain stem. The trigemino-cardiac reflex has been attributed as one of the causes. Here, we report two cases who suffered asystole during the resection of posterior fossa tumors. The vago-glossopharyngeal reflex and the direct stimulation of the brainstem were hypothesized as the causes of asytole. These episodes resolved spontaneously following withdrawal of the surgical stimulus emphasizing the importance of anticipation and vigilance during critical moments of tumor dissection during posterior fossa surgery.

Keywords: Asystole; brainstem manipulation; posterior fossa surgery; trigemino-cardiac reflex; vago-glossopharyngeal reflex.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Magnetic resonance imaging of brain showing left cerebellopontine angle mass lesion (arrow) compressing the brainstem
Figure 2
Figure 2
Flat line (asystole) in ECG lead II
See this image and copyright information in PMC

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