Review Article

Cardiac Emergencies in Neurosurgical Patients

Table 2

Cardiac emergencies in skull base surgery.

AuthorPatientProcedureCardiac rhythmCauseManagementOutcome

Cho et al. [12]3 patients 28–42 y; ♀ = 2, ♂ = 1Transsphenoidal pituitary resectionAsystole (); bradycardia ()TCR (cavernous sinus manipulation)Cessation of surgical manipulationNo neurological deficit
Abou-Zeid et al. [13]26 y ♀Transsphenoidal pituitary resectionAsystole (30 s)TCR (cavernous sinus manipulation)AtropineNo neurological deficit
Seker et al. [14]53 y ♂Transsphenoidal pituitary resectionAsystole (20 s)TCR (cavernous sinus manipulation)Cessation of surgical manipulation; atropineNo neurological deficit
Meng et al. [15] 1/100 patients (skull base surgery) 56 ♀Sphenoid wing meningiomaBradycardiaTCR NoneNo neurological deficit
Reddy et al. [16]40 y ♂RF-ablation (trigeminal neuralgia)Asystole and bradycardia (<1 min) TCRAtropineNo neurological deficit
Rath et al. [17]50 y ♂Transsphenoidal pituitary surgeryAsystole (10 s); pulseless bradycardia (30–40 s)Hypothalamic injuryAtropine; CPRCN 6 palsy, blindness
Stauber et al. [18]34 y ♀Pituitary adenoma resectionAsystoleTCRSternal punch, IV epinephrineNo neurological deficit
Ori et al. [19]34 y ♂Percutaneous thermocoagulation (petrous ganglion of Andersch)Bradycardia, asystole (5 s)GVRAtropine, CPRHypalgesia of auditory canal

♀ = female gender; ♂ = male gender; TCR = trigeminocardiac reflex; GVR = glossopharyngeal-vagal reflex; CN = cranial nerve; CPR = cardiopulmonary resuscitation including chest compressions; no neurological deficits = postoperative deficits not mentioned.