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We report a 35-year-old gentleman who presented to us with respiratory distress. He was diagnosed to have a large anterior mediastinal mass and was and posted for debulking of mediastinal mass. Immediately after intubation, airway collapsed and there was difficulty in ventilating the lungs, followed by drop in oxygen saturation. After sternotomy, oxygen saturation and airway pressures improved. In this report we discussed in detail about the successful anaesthetic considerations for patients with large anterior mediastinal tumour including the management of airway obstruction.

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Hydrocephalus is a disorder of abnormal accumulation of cerebrospinal fluid (CSF) in the ventricular system. Accumulation of CSF occurs due to an imbalance between CSF production and absorption. In the new-born and infants, hydrocephalus almost entirely presents as an enlarged head resulting from the separation of cranial bone plates, so any new-born or infant with an enlarged head should undergo evaluation. We report the case of a gross hydrocephalus in a 9-month-old infant (head circumference 55 cm) posted for ventriculoperitoneal shunt surgery with anaesthetic consideration of difficult intubation because of such a large head size, positioning, age-related pathophysiology and temperature regulation. The case was managed successfully with an uneventful hospital stay, and a significant decrease in head size was noted.

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