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Asystole during posterior fossa surgery: Report of two cases. 2012

Keshav Goyal, and Frenny Ann Philip, and Girija Prasad Rath, and Charu Mahajan, and M Sujatha, and Sachidanand Jee Bharti, and Nidhi Gupta
Department of Neuroanaesthesiology, All India Institute of Medical Sciences, New Delhi, India.

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.

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