Trigeminocardiac Reflex in Neurosurgery - Current Knowledge and Prospects

Abdulazim, Amr; Stienen, Martin N.; Sadr-Eshkevari, Pooyan; Prochnow, Nora; Sandu, Nora; Bohluli, Benham; Schaller, Bernhard

doi:10.5772/29607

Cited by 24 publications

(35 citation statements)

References 59 publications

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“…Based on the anatomy, scientists have suggested a hypothesis indicating that the reflex arc is formed by afferent and efferent pathways where the efferent pathway continues to connect with the motor nucleus of the vagus nerve, and as it is well known that the vagus nerve provides parasympathetic innervations to the smooth muscles, abdominal viscera, and heart, therefore, when the trigeminal nerve is stimulated, it results a reflexive response conducted by the vagus nerve, leading to bradycardia and asystole [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…The neurosurgeon should always warn the anesthesiologist if he/she approaches the nerve or its branches. In addition, the anesthesiologist should correct any hypoxia, hypercarbia, and acidosis before any surgical manipulation because they trigger the TCR [6]. Accordingly, the mean arterial blood pressure and the heart rate should constantly be monitored, so in case any hemodynamic changes are faced, the surgeon should be informed to stop his surgical maneuvers.…”

Section: Discussionmentioning

confidence: 99%

“…Still, if asystole and hypotension persist after the cessation of the manipulation an anticholinergic should be administered whether it is atropine or glycopyrrolate [6].…”

Section: Discussionmentioning

confidence: 99%

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Asystole Due to Saline Irrigation during a Posterior Fossa Surgery: A Case Report

Abdelmassih¹

2015

J Anesth Clin Res

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Posterior fossa surgery (PFS) is one of the most complicated surgeries in the neurosurgery field. Asystole is a severe complication during this type of surgeries. Trigemino cardiac reflex (TCR) is hypothesized to stimulate the asystole. The case of a 40 year old female who established a cardiac arrest is reported when the surgeon was flooding the field with normal saline at the end of the surgery. A good knowledge of TCR is important and a close monitor should continue till the end of surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Asystole Due to Saline Irrigation during a Posterior Fossa Surgery: A Case Report

Abdelmassih¹

2015

J Anesth Clin Res

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“…Later, all these reflexes were subsumed under the term TCR. 2,3,24,25 Therefore, the TCR may now be subtyped on the basis of its trigger points: the central (proximal) TCR is triggered upon stimulation of the intracranial course of the trigeminal nerve (i.e., from the Gasserian ganglion (GG) to the brain stem); the peripheral (distal) TCR is elicited upon stimulation of the trigeminal nerve anywhere along its course outside the cranium to the GG. The peripheral TCR is further subdivided into the oculocardiac reflex (OCR) and the maxillomandibulocardiac reflex (MCR) on the basis of the branches of the affected trigeminal nerve.…”

Section: References 31mentioning

confidence: 99%

“…The peripheral TCR is further subdivided into the oculocardiac reflex (OCR) and the maxillomandibulocardiac reflex (MCR) on the basis of the branches of the affected trigeminal nerve. 25 At present, the TCR is defined as involving a decrease in HR and a mean arterial blood pressure (MABP) of at least 20% of the baseline upon surgical manipulation at or around any sensory branch of the trigeminal nerve. [1][2][3]7,24 However, this definition may not able to detect subtle TCR episodes and therefore is likely to underestimate the true incidence of the reflex.…”

Section: References 31mentioning

confidence: 99%

The Trigeminal Nerve

Spiriev

Chowdhury

Schaller

2015

Trigeminocardiac Reflex

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UniversitätsSpital Zürich: 80 years of neurosurgical patient care in Switzerland

et al. 2017

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BackgroundThe predecessor of today’s Department of Neurosurgery, UniversitätsSpital Zürich (USZ), was founded 80 years ago as the first independent Swiss clinic dedicated to neurosurgical patient care. On the occasion of this anniversary, we aimed to highlight the history of neurosurgery as a specialty at the USZ, and to put it into the historical context of Swiss and European Neurosurgery.MethodA literature review was conducted and we searched the archives of the USZ and the city of Zurich, as well as those of Swiss journals to extract relevant published articles, books, historical reports and pictures. The USZ Department of Medical History, the Museum of Medical History and the Swiss National Library were contacted to provide source material. To further verify the content, (emeritus) faculty from the USZ and external experts on the history of Swiss neurosurgery reviewed the manuscript.ResultsSurgeries of the head and spine had occasionally been conducted in Zurich by the general surgeons, Rudolf Ulrich Krönlein and Paul Clairmont, before an independent neurosurgical clinic was founded by Hugo Krayenbühl on 6 July 1937. This was the first Swiss department dedicated to neurosurgical patient care. Besides providing high-quality medicine for both the local and wider population, the department was chaired by eminent leaders of neurosurgery, who influenced the scientific and clinical neurosurgery of their time. As such, it has long been regarded as one of the top teaching and research hospitals in Switzerland and in Europe.ConclusionsOn the occasion of its 80th anniversary, we have performed an in-depth review of its development, successes and challenges, with a special focus on the early decades. Reflecting on the past, we have identified common denominators of success in neurosurgery that remain valid today.Electronic supplementary materialThe online version of this article (10.1007/s00701-017-3357-z) contains supplementary material, which is available to authorised users.

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Trigeminocardiac Reflex in Neurosurgery - Current Knowledge and Prospects

Cited by 24 publications

References 59 publications

Asystole Due to Saline Irrigation during a Posterior Fossa Surgery: A Case Report

Asystole Due to Saline Irrigation during a Posterior Fossa Surgery: A Case Report

The Trigeminal Nerve

UniversitätsSpital Zürich: 80 years of neurosurgical patient care in Switzerland

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