ASYSTOLE AS A NEUROLOGIC SIGN

The authors present a case of asystole occurring during dural closure following craniotomy with the patient in the supine position. This 22- year-old woman had a left parietal lobe tumor resected with bipolar ca utery. Standard intraoperative monitoring with a left radial arterial line and a right internal jugular central venous catheter was used dur ing the surgery. The anesthetic course was complicated by intraoperati ve bleeding that responded to three units of fresh frozen plasma. Prio r to closure, the operative site appeared dry and intact. After closur e, asystole occurred suddenly and resolved with evacuation of 500 ml o f blood. It is speculated that the asystole was preceded by an acute i ncrease in intracranial pressure and a subsequent secondary brainstem compression.