PDF(Pubmed)
Abstract：
Lesions at the cerebellopontine angle (CP angle) are associated with various brain-heart interactions, which can include those from stimulation of the fifth cranial nerve along the scalp incision in a retrosigmoid suboccipital surgical approach. A 27-year-old male patient with recently diagnosed hypertension (on calcium channel blocker) underwent left CP angle lesion decompression. Transient episodes of bradycardia, hypotension, and bradypnea were observed from the skin incision onward, exacerbated during tumor manipulation. Most episodes subsided with cessation of the surgical stimulus while some required intervention. Postoperatively, blood pressure decreased below the pre-operative levels. Thus, trigeminocardiac reflex can occur as early as the skin incision even in a retrosigmoid approach due to stimulation of the mandibular division, when specific risk factors exist. Such episodes may serve as early warning signs for subsequent intraoperative occurrences. Brainstem compression can be a possible etiology of hypertension in young patients. It underscores the importance of considering brain-heart interactions in surgical interventions involving the CP angle.
摘要：
小脑桥脑角（CP角）的病变与各种脑-心脏相互作用有关，其中包括在乙状枕下后手术入路中沿着头皮切口刺激第五颅神经的刺激。一名最近诊断为高血压（使用钙通道阻滞剂）的27岁男性患者接受了左CP角病变减压术。短暂的心动过缓发作,低血压,从皮肤切口向前观察到呼吸缓慢，在肿瘤操作期间加剧。大多数发作随着手术刺激的停止而消退，而有些则需要干预。术后,血压低于术前水平。因此，由于刺激下颌分裂，即使在乙状窦后入路，三叉神经心反射也可以在皮肤切口早期发生，当存在特定风险因素时。此类发作可用作后续术中发生的早期预警信号。脑干压迫可能是年轻患者高血压的可能病因。它强调了在涉及CP角度的外科手术中考虑脑-心脏相互作用的重要性。
