Thought I'd post a few images of what we operate here. This 65 year old was bed ridden because of severe cerebellar ataxia for last six months. Due to lack of support from family she didnt undergo treatment despite a CTscan diagnosis 3 months back.
Surgery- midline suboccipital craniotomy and subtotal excision. [actually intraop impression was gross total excision, but some tumor stuck to the obex and that exiting beyond the foramina of Lushka were left behind to avoid unacceptable deficits.] *surgeons:I and Hari.
intraoperative events and problems encountered: Blood pressure rose to 200/160 as the tumor was decompressed although no significant maniulation of the floor of the fourth ventricle occurred. Controlled with propofol infusion. Bp remined high in immediate postop period. [NTG patch now].
operating microscope [the chinese make borrowed from plastic surgery] malfunctioned and surgery was done without it!
outcome: no new deficits except mild gag tolerence. however she experienced near aspiration on attempted feeding. Indirect laryngoscopy showed fixed left vocal cord. So she was maintained on ryles tube feeds until the right cord started compensating. Relatives refused the option of gastrostomy.
Surgery- midline suboccipital craniotomy and subtotal excision. [actually intraop impression was gross total excision, but some tumor stuck to the obex and that exiting beyond the foramina of Lushka were left behind to avoid unacceptable deficits.] *surgeons:I and Hari.
intraoperative events and problems encountered: Blood pressure rose to 200/160 as the tumor was decompressed although no significant maniulation of the floor of the fourth ventricle occurred. Controlled with propofol infusion. Bp remined high in immediate postop period. [NTG patch now].
operating microscope [the chinese make borrowed from plastic surgery] malfunctioned and surgery was done without it!
outcome: no new deficits except mild gag tolerence. however she experienced near aspiration on attempted feeding. Indirect laryngoscopy showed fixed left vocal cord. So she was maintained on ryles tube feeds until the right cord started compensating. Relatives refused the option of gastrostomy.
1 comment:
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