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Case Report

RMJ. 2017; 42(4): 609-612

Hypoxic brain damage caused by peripheral trigerminocardiac reflex after surgery of pituitary adenoma via transsphenoidal approach

Ki Hwa Lee, Hyun Ji Jo, Hyojoong Kim, Myoung Jin Ko, Jae Hong Park.


Transsphenoidal approach (TSA) for the lesion of the sellar area is well-established technique. Trigerminocardiac reflex (TCR) occurs during skull base surgery and is known to be self-limiting. We present a case of a 47-year-old woman who underwent second operation of pituitary adenoma using TSA. During operation, there was a decrease of mean arterial blood pressure from 106 mmHg to 82 mmHg, and an accompanying decrease of the heart rate from 68 beats/min to 40 beats/min, which was treated with 0.25mg atropine. After the operation, she developed repeated seizure attacks. Computed tomography findings suggested hypoxic brain damage and TCR was suspected as the cause.

Key words: hypoxic brain damage; transsphenoidal surgery; trigerminocardiac reflex

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