Lalenoh, Diana Christine
ANESTHESIA OF THE POSTERIOR FOSSA SURGERY.
NEUROANESTHESIA AND CRITICAL CARE (NACC) COURSE SEPTEMBER 19TH-20ST 2014.
Abstract
The posterior fossa or the infratentorial fossa is a rigid compartement with poor compliance and houses important structures such as the brainstem and cerebellum. Tumours are the commonest pathology affecting the posterior fossa and they account for up to two-thirds of brain tumours in children. The posterior fossa or infratentorial fossa is a compact and rigid compartment with poor compliance. Small additional volumes (e.g. tumour, haematoma) within the space can result in significant elevation of the compartmental pressure resulting in life-threatening brainstem compression. Surgery in the posterior fossa presents the anaesthetist with significant challenges.The sitting position offers better surgical access particularly in midline tumours but can be a significant challenge for anaesthetists. Venous air embolism is a potentially life-threatening complication associated with surgery on the posterior fossa in the sitting position. Anaesthetic management of paediatric posterior fossa surgery should take account of the principles of both paediatric and neuroanesthesia.
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