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Transient Neurological Dysfunction and Intracranial Hypertension After Tourniquet Deflation in a Patient With a Head
Ankur Khandelwal1, Aarti Srivastava1, Sudhansu Sekhar Nayak2
1From the Department of Anaesthesiology and Critical Care, Sharda University School of Medical Sciences and Research, Greater Noida, Uttar Pradesh, India.
Tourniquets can cause serious physiological changes. A case study highlights transient neurological dysfunction and intracranial hypertension in a teenager after tourniquet deflation, emphasizing risks in compromised patients.
Area of Science:
- Neurology
- Anesthesiology
- Surgical Complications
Background:
- Tourniquets are essential surgical tools for creating a bloodless field and minimizing blood loss.
- However, tourniquet use can lead to significant physiological alterations during inflation and deflation.
- These alterations may pose risks, particularly for patients with pre-existing health conditions.
Observation:
- A 15-year-old patient with a head injury underwent a surgical procedure involving a tourniquet.
- Following tourniquet deflation, the patient exhibited concerning physiological signs.
- These included bradyarrhythmia and an elevated optic nerve sheath diameter, indicative of increased intracranial pressure.
Findings:
- The patient experienced transient neurological dysfunction after tourniquet deflation.
- Intracranial hypertension was diagnosed under general anesthesia.
- Diagnosis was supported by bradyarrhythmia and ultrasonographic findings of elevated optic nerve sheath diameter.
Implications:
- This case underscores the potential for tourniquet deflation to precipitate neurological complications.
- Intracranial hypertension is a critical concern that requires prompt recognition and management.
- Clinicians should be vigilant for these risks in patients with head injuries or other compromised conditions undergoing tourniquet use.
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