Review Article

Cardiac Emergencies in Neurosurgical Patients

Table 1

Cardiac emergencies in supratentorial surgery.

AuthorPatient ()
(age/sex)
ProcedureCardiac rhythmCauseManagementOutcome

Chowdhury and West [3]50 y ♀Awake craniotomy (frontal tumor)Bradycardia, asystole (25 s)TCR
(scalp traction)
Release scalp traction; cessation propofol and remifentanil infusionsNo neurological deficit
Prabhu et al. [4]65 y ♂Awake craniotomy (temporal tumor) Bradycardia and asystole (8–10 s × 2 times)TCR
(dura cautery)
Cessation of cautery, atropineNo neurological deficit
Sinha et al. [5]18 y ♂Epilepsy surgery Bradycardia (2 episodes), asystole (9 s)Parasympathetic response 2° to amygdala resection; warm and cold saline irrigationAtropine; cessation of stimulusNo neurological deficit
Sato et al. [6]6/42 18–34 y; ♀ = 3, ♂ = 2Epilepsy surgerySinus bradycardia (<1 min)Parasympathetic tone 2° to limbic stimulationProcedure interruption; atropineNo neurological deficit
Tyler et al. [7]22 y ♀Craniotomy (parietal tumor)AsystoleIntracranial hematoma (dural closure)Hematoma evacuationNo neurological deficit
Wasnick et al. [8]70 ♂Epidural suction drainSevere bradycardiaIntracranial hypotensionRelease of suctionNo neurological deficit
Alfery et al. [9]18 ♀VP shuntVT, VFIntracranial hypotensionLidocaine, CPRNo neurological deficit
Karamchandani et al. [10]65 ♀Subgaleal suction drainMultiple severe bradycardiaIntracranial hypotensionRelease of suction, atropineNo neurological deficit
Bhagat et al. [11]2 patients  
both 60 ♂
Subgaleal suction drainSevere bradycardia, AsystoleIntracranial hypotensionRelease of suction, atropineNo neurological deficit

♀ = female gender; ♂ = male gender; TCR = trigeminocardiac reflex; no neurological deficit = postoperative deficit not mentioned.