1/7. Nasopharyngeal carcinoma with distant metastasis.We report a case of nasopharyngeal carcinoma with Chest Metastasis in a 38-year-old man. The patient presented with nasal obstruction, epistaxis, a huge neck mass and conductive hearing loss in the right ear. Examination under anaesthesia revealed a mass in the nasopharynx, which was confirmed on histology to be squamous carcinoma. He responded remarkably well to external radiotherapy with disappearance of primary tumor and neck metastasis. One year later he presented with thoraco-lumbar spine pain and cough. The nasopharynx and neck remained free of tumor while radiographs demonstrated multiple metastasis to the lungs and vertebrae.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/7. Lumbar ependymoma presenting with paraplegia following attempted spinal anaesthesia.Neurological deterioration from intraspinal haematoma following insertion of a spinal needle is extremely rare. We present the case of a 28-yr-old female, who presented with complete paraplegia following attempted spinal anaesthesia for delivery of her third child. Space-occupying iatrogenic spinal haemorrhage from a previously undiagnosed lumbar ependymoma was found to be the precipitating cause. Following laminotomy with blood clot and tumour removal her neurological function improved.- - - - - - - - - - ranking = 5keywords = anaesthesia (Clic here for more details about this article) |
3/7. paraplegia associated with combined spinal-epidural anaesthesia caused by preoperatively unrecognized spinal vertebral metastasis.We describe a case of paraplegia following combined spinal-epidural anaesthesia. It was postoperatively determined that a tumour of the vertebrae which was compressing the spinal cord was responsible for this complication. We suggest that the pre-existing pathology of the spine must be borne in mind as a differential diagnosis of acute postoperative paraplegia.- - - - - - - - - - ranking = 5keywords = anaesthesia (Clic here for more details about this article) |
4/7. Asystole during percutaneous ethanol injection of symptomatic vertebral haemangioma.Computed tomography guided percutaneous ethanol injection is frequently employed for treatment of symptomatic vertebral haemangiomas. The procedure is performed under monitored anaesthesia care in the prone position. It has several advantages over open surgery and other therapeutic modalities and is generally considered safe. There is no previous report of any significant haemodynamic disturbance attributable to alcohol ablation of vertebral haemangiomas. We report a case in which a patient of ASA physical status I developed asystole following injection of 100% alcohol into a vertebral haemangioma, and became apnoeic and unresponsive. He recovered following intravenous administration of atropine. All staff involved in this procedure should be aware of and prepared for, this rare but potentially life-threatening complication.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/7. Anaesthesia for removal of carcinoid metastases. A case of serotonin-secreting secondary tumour in the lumbar spine.A case of general anaesthesia for removal of carcinoid metastases is presented. Evidence of serotonin hypersecretion was shown by raised levels of 5-hydroxyindoleacetic acid, hypertension and tachycardia. The rarity of osteoblastic carcinoid metastases is discussed.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
6/7. Transporting patients with overwhelming pain.The use of ketamine anaesthesia is described for the transport from home to hospital of patients in severe pain secondary to malignant disease. The technique is simple and highly effective and introduces a new role for anaesthetists and pain relief specialists.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
7/7. paraplegia following transurethral surgery.We have presented a case of paraplegia following spinal anaesthesia administered for a transurethral prostatic resection. Further investigation revealed a metastatic peridural compressive lesion at the level of T4. We have discussed some of the contributory factors involved, chiefly the lumbar puncture (perimedullary vascular engorgement, alterations in C.S.F. dynamics) and the possible role of intra-operative water intoxication (swelling of spinal cord cells).- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |