Anaes · Neuroanaesthesia
Posterior fossa surgery: cranial nerves, brainstem reflexes, and positioning
Also known as CPA surgery anaesthesia · Posterior fossa craniotomy · Trigeminocardiac reflex
Anaesthesia for posterior fossa and CPA surgery including positioning trade-offs, cranial nerve and brainstem monitoring constraints, trigeminocardiac reflex, VAE risk, and emergence planning.
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10 MCQs with explanations
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Why this is examined / the one-line answer
Posterior fossa and cerebellopontine angle (CPA) surgery combines positioning physiology, venous air embolism (VAE) risk, brainstem cardiovascular reflexes, and cranial nerve (CN V–XII) injury that changes extubation safety. It is high-yield SS_NS Final material because a single stem can test VAE, trigeminocardiac reflex, facial nerve monitoring constraints, and delayed airway failure from bulbar dysfunction. [1]
One-line opener: Stop surgical stimulus first for sudden bradycardia, keep VAE on the differential when the head is up, and do not extubate a patient who cannot protect the airway because lower cranial nerves are injured. [1]
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- [1]Goettel N et al. Dexmedetomidine vs propofol-remifentanil conscious sedation for awake craniotomy: a prospective randomized controlled trial Br J Anaesth, 2016.PMID 27099154
- [2]Frerk C et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults Br J Anaesth, 2015.PMID 26556848
- [3]Lewis SC et al. General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial Lancet, 2008.PMID 19041130