Anesthetic Management and Considerations in a Rare Case of Parietal Bone Hemangioma

Abstract

Parietal bone hemangiomas represent a minority of diagnosed brain tumors. These lesions require careful management under anesthesia due to their vascularity and cranial location. We discuss a 31-year-old female with chronic headaches who underwent surgery for the removal of a large parietal bone hemangioma, necessitating considerations for stable hemodynamics, intracranial pressure (ICP), and bleeding risks. There is no standard anesthetic for these cases, so a mixed anesthetic approach was used, combining intravenous anesthesia with sevoflurane, aimed at optimizing control during the procedure.

Keywords: anesthetic considerations; neuroanesthesia; parietal bone hemangiomas; total intravenous anesthetic; volatile anesthetic.

Figure 1. MRI brain T2 axial flair (27.1 mm)

This is the initial imaging for the patient's brain masses found on MRI, suggestive of parietal bone hemangioma. MRI, magnetic resonance imaging

Figure 2. MRI brain T2 axial flair

This is the follow-up imaging for the patient's brain masses found on MRI, showing growth of the right-sided lesion with the stable left-side lesion. MRI, magnetic resonance imaging