Failure to awaken after general anaesthesia secondary to paradoxical venous embolus. uri icon

Overview

abstract

  • A patient is presented who failed to regain consciousness after an apparently uneventful nine-hour revision of a total hip replacement. There were no clinically important haemodynamic changes during the operation, and oxygen saturation, capnography and acid base balance were normal throughout. Postop CT of the head showed a large left MCA infarct with midline shift. At autopsy, the patient was found to have a previously unsuspected patent foramen ovale, and a venous embolus in the left internal carotid artery, which probably had originated from the periprostatic venous plexus with a large infarct in the distribution of the left anterior and middle cerebral arteries. The authors conclude that massive paradoxical venous emboli can occur during surgery with minimal haemodynamic changes.

publication date

  • April 1, 1991

Research

keywords

  • Anesthesia, General
  • Intracranial Embolism and Thrombosis
  • Unconsciousness

Identity

Scopus Document Identifier

  • 0025806532

Digital Object Identifier (DOI)

  • 10.1007/BF03007624

PubMed ID

  • 2036694

Additional Document Info

volume

  • 38

issue

  • 3