Anaesthetic Management of a Case of Parkinson’s Disease with Extradural Haematoma and Atrial Flutter Posted for Emergency Craniotomy
Published: July 1, 2024 | DOI: https://doi.org/10.7860/JCDR/2024/70918.19658
Dipika Balasubramanian, Arun Ganesan, Richards Sam, Bhagyavardthan Botta, Kala Balasubramanian
1. Junior Resident, Department of Anaesthesiology, Sree Balaji Medical College and Hospitals BIHER, Chennai, Tamil Nadu, India.
2. Junior Resident, Department of Anaesthesiology, Sree Balaji Medical College and Hospitals BIHER, Chennai, Tamil Nadu, India.
3. Senior Resident, Department of Anaesthesiology, Appollo Hospitals, Chennai, Tamil Nadu, India.
4. Assistant Professor (Consultant), Department of Anaesthesiology, Sree Balaji Medical College and Hospitals BIHER, Chennai, Tamil Nadu, India.
5. Professor, Department of Anaesthesiology, Sree Balaji Medical College and Hospitals BIHER, Chennai, Tamil Nadu, India.
Correspondence
Dr. Kala Balasubramanian,
Professor, Department of Anaesthesiology, Sree Balaji Medical College and Hospital, CLC Works Road, Chrompet, Chennai-600044, Tamil Nadu, India.
E-mail: kalamhn@gmail.com
Parkinson’s Disease (PD) patients are more prone to traumatic injury due to a short shuffling gait and skeletal muscle rigidity. Diabetes mellitus is a chronic metabolic syndrome that affects all vital systems, including the autonomic nervous system. Cardiac autonomic neuropathy affects the conducting system of the heart, producing cardiac arrhythmias and silent ischaemia. Here, the authors report a case of head injury with Extradural Haematoma (EDH) in a 81 year old geriatric male patient posted for EDH evacuation. Emergency craniotomy in this patient with pre-existing PD, diabetes mellitus, and new-onset atrial flutter presents a significant challenge in anaesthetic management. In addition to that, chronic alcoholism further necessitates the selection of appropriate anaesthetic techniques and vigilant perioperative management to prevent intraoperative cardiac arrhythmias, hypotension, heart failure, and pulmonary oedema.
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