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CC BY 4.0 · J Neuroanaesth Crit Care 2023; 10(02): 109-111
DOI: 10.1055/s-0042-1756432
Case Report

Awake Craniotomy for Cerebral Abscess with Pulmonary Arteriovenous Malformation

Saloni K. Shah 
1   Department of Anaesthesia, Seth Gordhandas Sunderdas Medical College and King Edward (VII) Memorial Hospital, Mumbai, Maharashtra, India
,
Anita Shetty 
1   Department of Anaesthesia, Seth Gordhandas Sunderdas Medical College and King Edward (VII) Memorial Hospital, Mumbai, Maharashtra, India
,
Dhairal Mehta 
1   Department of Anaesthesia, Seth Gordhandas Sunderdas Medical College and King Edward (VII) Memorial Hospital, Mumbai, Maharashtra, India
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Abstract

A cerebral abscess can be a life-threatening complication of pulmonary arteriovenous malformations (PAVM), thus posing significant morbidity if left untreated. We report a case of an incidental finding of a PAVM in a patient diagnosed with cerebral abscess. A 22-year-old male presented to the emergency department with acute onset right-sided weakness in both upper and lower limbs for 1 week. Magnetic resonance imaging showed a ring-enhancing lesion within the left parasagittal frontoparietal region s/o intracerebral abscess. High-resolution computed tomography was done as a protocol in patients posted for surgery due to coronavirus disease 2019 and coincidentally, it showed a single well-defined parenchymal nodule, 4 × 3.4 cm in the lateral basal segment of the left lower lobe. The knowledge of the pathophysiology of PAVM and expected complications during general anesthesia (GA) and positive pressure mechanical ventilation is essential. In such conditions, awake craniotomy under conscious sedation and scalp block may be considered as an alternative to GA.

Keywords

awake craniotomy - pulmonary arteriovenous malformation - dexmedetomidine - conscious sedation - cerebral abscess


Publication History

Article published online:
17 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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