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Author Unnikrishnan, K. P. ♦ Sinha, P. K. ♦ Sriganesh, Kamath ♦ Suneel, Puthuvassery Raman
Source Sree Chitra Tirunal Institute for Medical Sciences & Technology
Content type Text
Publisher Canadian Journal of Anaesthesia-journal Canadien D Anesthesie
File Format PDF
Language English
Subject Domain (in DDC) Technology ♦ Medicine & health ♦ Diseases
Subject Domain (in MeSH) Cardiovascular Diseases ♦ Diseases ♦ Therapeutics ♦ Anesthesia and Analgesia ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Health Care Facilities, Manpower, and Services ♦ Health Care
Subject Keyword Critical Care
Abstract Purpose: We report a case of bispectral index (BIS) failing to zero during absolute alcohol embolization of an intracranial arteriovenous malformation (AVM) under anesthesia. This case highlights the unusual effect of a therapeutic dose of parenteral alcohol on the central nervous system using BIS monitoring.Clinical features: A 29-yr-old male with a left parieto-occipital arteriovenous malformation underwent neuroendovascular embolization under general anesthesia. During injection of absolute alcohol injection into the AVM niclus, the patient developed hypertension and tachycardia coincident with a profound and sustained reduction of BIS values to zero, despite a stable level of anesthesia. Immediate angiography revealed no evidence of hemorrhage or new changes in the patient's cerebral vasculature. Post-procedure, the patient remained drowsy for several hours with signs of alcohol intoxication. He had full neurological recovery.Conclusions: In the presence of normal cerebral angiographic findings, suppression of BIS values may serve as an early indicator of CNS responses to intracranial injection of absolute alcohol for embolization of an arteriovenous malformation.
Education Level UG and PG
Learning Resource Type Article
Educational Framework Medical Council of India (MCI)
Volume Number 54
Issue Number 11
Page Count 4
Starting Page 908
Ending Page 911