1/6. Posterior fossa surgery in the sitting position in a pregnant patient with cerebellopontine angle meningioma.Primary brain tumours and pregnancy rarely occur together; meningioma and pregnancy is rarer still. We describe a 30-yr-old woman in the 25th week of pregnancy who underwent surgery in the sitting position for a large cerebellopontine angle meningioma that was compressing and displacing the pons and medulla. The surgical procedure and postoperative period were uneventful. This case demonstrates that when absolutely necessary, anaesthesia and neurosurgery for posterior fossa lesions can be successful during the second trimester of pregnancy. Furthermore, if indicated and if the operating team is experienced, the operation can be performed safely with the patient in the classical sitting position. It is emphasized that continuous and attentive monitoring of the mother and fetus are essential.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/6. hypnosis instead of general anaesthesia in paediatric radiotherapy: report of three cases.PURPOSE: This report proposes hypnosis as a valid alternative to general anaesthesia for immobilisation and set-up in certain cases in paediatric radiotherapy. methods: We report three cases of children who underwent radiotherapy in 1994 and were treated using hypnosis for set-up during irradiation. The first and the second were two cases of macroscopic resection of cerebellar medulloblastoma in which craniospinal irradiation was necessary, while the third patient suffered of an endorbitary relapse of retinoblastoma previously treated with bilateral enucleation, radiotherapy and chemotherapy; in this last situation the child needed radiation as palliative therapy. hypnosis was used during treatment to obtain the indispensable immobility. Hypnotic conditioning was obtained by our expert psychotherapist while the induction during every single treatment was made by the clinician, whose voice was presented to the children during the conditioning. RESULTS: Every single fraction of the radiation therapy was delivered in hypnosis and without the need for narcosis. CONCLUSIONS: hypnosis may be useful in particular situations to prepare paediatric cancer patients during irradiation, when lack of child collaboration might necessitate the use of general anaesthesia and when anaesthesia itself is not possible.- - - - - - - - - - ranking = 7keywords = anaesthesia (Clic here for more details about this article) |
3/6. Epidural anaesthesia for Caesarean section in a patient with von hippel-lindau disease.von hippel-lindau disease is a rare autosomal dominant disease with incomplete penetrance and variable expression and is characterized by diffuse haemangioblastomas of the central nervous system and viscera. The majority of the central nervous system lesions are located in the cerebellum. This report describes the successful management with epidural anaesthesia of a woman with a term gestation, von hippel-lindau disease and cerebellar haemangioblastoma.- - - - - - - - - - ranking = 5keywords = anaesthesia (Clic here for more details about this article) |
4/6. Successful treatment of a haemangioblastoma in a 95 year-old patient. Case report.Haemangioblastomas located in the posterior fossa have rarely been described in patients older than 60 years of age. The authors report a case of a 95 year-old man who presented with an obstructive hydrocephalus secondary to a posterior fossa tumour. Computed tomography and angiography suggested intracerebellar metastasis. Despite the advanced age of the patient and his poor general condition, surgery was performed with the patient in a supine position. A haemiangioblastoma was found and completely removed. The postoperative course was without complications. This case demonstrates that the combination of modern anaesthesia, supine operating position, and the use of microsurgical techniques allow successful operations on the posterior fossa even in very old patients.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/6. Repeat ketamine anaesthesia of a child for radiotherapy in the prone position.Sixteen ketamine anaesthetics over an eight-week period for a course of postoperative radiotherapy following removal of a medulloblastoma in an 18-month-old child are described. On each occasion the child was in the prone position with a tight fitting shell covering the head, trunk and arms. The problems of repeated anaesthetics, isolation of the child in one room from the anaesthetist in another, and psychological upset to the mother and child are discussed. ketamine was chosen because with this agent the patient usually maintains a clear airway, even in unusual postures. It was used successfully by both the intramuscular and rectal routes, thus avoiding repeated venepuncture and intubation. Post-anaesthetic nausea was a problem, but tolerance to ketamine and psychological emergence phenomena did not occur.- - - - - - - - - - ranking = 4keywords = anaesthesia (Clic here for more details about this article) |
6/6. pneumocephalus as a complication of posterior fossa surgery in the sitting position.A case of pneumocephalus complicating posterior fossa surgery in the sitting position is presented. Rapid diagnosis was obtained by computerised tomography. This condition should be suspected whenever a patient demonstrates delayed recovery or neurological deficit after craniotomy and nitrous oxide anaesthesia. The literature on the subject is reviewed.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |