Pulmonary Edema After Intracranial Aneurysm Clipping in Kyphosis: A Case Report

A 56-year-old female patient was admitted to the hospital for "10+days of right eye droop and 1 day of aggravation". After admission, the physical examination found that the patient had severe scoliosis. 3D reconstruction and enhanced CT scan of the head vessels showed that the right internal carotid artery C6 aneurysms were clipped under general anesthesia. After the operation, the patient had increased airway pressure, with a large number of pink foam sputum attracted from the trachea catheter, and the lungs were scattered with moist rales during auscultation, After the treatment of anti-heart failure, the patient returned to the ICU through the trachea catheter. Eight hours later, the trachea catheter was pulled out and the patient was released from the ventilator. The symptoms were relieved on the fifth day after the operation. This case report describes the perioperative management of intracranial aneurysm with severe scoliosis. After strict monitoring and timely treatment during the perioperative period, the patient turned from crisis to safety, providing some reference for colleagues who encounter such patients in the future.

In patients with scoliosis, due to long-term compression of the thorax, pulmonary restrictive ventilation dysfunction, small airway function and diffusion function are reduced, and cardiac function is decreased. Therefore, during the operation of intracranial aneurysms, fluid infusion should be careful, and volume monitoring should be done at all times to maintain the effective circulating blood volume of the body and prevent the aggravation of cardiac insufficiency and pulmonary edema.