Increased intracranial pressure after massive blood loss -A case report-

다국어 초록 (Multilingual Abstract)

A 4-year old boy with supravalvular ascending aortic stenosis underwent sliding aortoplasty. After cardiopulmonary bypass weaning, aorta suture site was torn accidentally and the patient was in hypovolemic shock. Emergency cardiopulmonary bypass was reinstituted and the aorta was repaired. After removal of the aortic clamp, bradycardia and hypertension were noted. We suspected increased intracranial pressure due to hypoxic brain damage after massive blood loss and the patient was treated to lower the intracranial pressure. Physicians should be aware of the significance of the hemodynamic change associated with increased intracranial pressure to prevent further neurologic damage.

참고문헌 (Reference)

1 Agrawal A, "Waghmare LB. Bradycardia in neurosurgery" 110 : 321-327, 2008

2 Kalmar AF, "Value of Cushing reflex as warning sign of brain ischaemia during neruoendoscopy" 94 : 791-799, 2005

3 Cushing H, "The blood pressure reaction of acute cerebral compression, illustrated by cases of intracranial hemorrhage" 125 : 1017-1044, 1903

4 Kofke WA, "Monitoring and intraoperative management of elevated intracranial pressure and decompressive craniectomy" 25 : 579-603, 2007

5 Rangel-Castilla L, "Management of intracranial hypertension" 26 : 521-541, 2008

6 Doba N, "Localization within the lower brain stem of a receptive area mediating the pressor response to increased intracranial pressure (the Cushing response)" 47 : 487-491, 1972

7 Tan ST, "Cerebral oximetry in cardiac surgery" 14 : 220-225, 2008