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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2023; 42(03): e246-e249
DOI: 10.1055/s-0043-1775555
Case Report

Modified 30-Degree Head-Up Tilt Park Bench Position in Semielective Posterior Fossa Surgery in a Patient with Pheochromocytoma

Posição de banco de apoio de inclinação de cabeça para cima de 30 graus modificada em cirurgia de fossa posterior semieletiva em paciente com feocromocitoma

Authors

  • Sevtap Hekimoglu Sahin 

    1   Department of Anesthesiology and Reanimation, Trakya University Medical Faculty, Edirne, Turkey

  • Osman Simsek 

    2   Department of Neurosurgery, Trakya University Medical Faculty, Edirne, Turkey

  • Tolgay Akinci 

    2   Department of Neurosurgery, Trakya University Medical Faculty, Edirne, Turkey

  • Zafer Cakici 

    1   Department of Anesthesiology and Reanimation, Trakya University Medical Faculty, Edirne, Turkey
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Abstract

Von Hippel–Lindau (VHL) disease is a rare genetic disorder associated with the central nervous system and visceral organs. Pheochromocytomas occur in 10% of VHL patients, while cerebellar tumors are common tumors in VHL syndrome, with an incidence of 60%. The most common position for posterior fossa operations is the park bench or lateral decubitus position. These positions have primarily replaced the sitting position. However, the advantages of the supine position cannot be overlooked. The coexistence of pheochromocytoma and the cerebellar tumor may require modification in surgical position and anesthesia management in line with possible pathophysiological changes. We present the anesthesia management in posterior fossa surgery in patients with postponed pheochromocytoma surgery. The present case highlights the importance of a multidisciplinary team approach and anesthetic management.

Resumo

A doença de Von Hippel-Lindau (VHL) é uma doença genética rara associada ao sistema nervoso central e órgãos viscerais. Feocromocitomas ocorrem em 10% dos pacientes com VHL, enquanto os tumores cerebelares são tumores comuns na síndrome de VHL, com incidência de 60%. A posição mais comum para operações da fossa posterior é o banco do parque ou posição de decúbito lateral. Essas posições substituíram principalmente a posição sentada. No entanto, as vantagens da posição supina não podem ser negligenciadas. A coexistência de feocromocitoma e tumor cerebelar pode exigir modificação da posição cirúrgica e manejo da anestesia de acordo com possíveis alterações fisiopatológicas. Apresentamos o manejo da anestesia na cirurgia da fossa posterior em pacientes com cirurgia de feocromocitoma adiada. O presente caso destaca a importância de uma abordagem de equipe multidisciplinar e do manejo anestésico.

Keywords

von hippel–lindau - park bench position - pheochromocytoma - general anesthesia

Palavras-chave

von hippel - lindau - posição de banco de parque - feocromocitoma - anestesia geral

Informed Consent

Written informed consent was obtained from the patient who participated in the present study.


Financial Disclosure

The authors declare that the present study has received no financial support.




Publikationsverlauf

Eingereicht: 06. April 2021

Angenommen: 30. Juli 2021

Artikel online veröffentlicht:
29. September 2023

© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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