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Anesthesia and analgesia · Jun 2012
Case ReportsFocal cerebral ischemia after surgery in the "beach chair" position: the role of a congenital variation of circle of Willis anatomy.
- John C Drummond, Roland R Lee, and James P Howell.
- Department of Anesthesiology, VA Medical Center, San Diego, CA 92161, USA. jdrummond@ucsd.edu
- Anesth. Analg.. 2012 Jun 1;114(6):1301-3.
AbstractA 50-year-old man underwent shoulder surgery in the beach chair position. His mean arterial blood pressure at arm level was approximately 65 mm Hg. Postoperatively, there was delayed awakening and a right hemiparesis. Radiologic evaluation revealed a congenital asymmetry of the circle of Willis that resulted in limited collateral flow to the left anterior and middle cerebral artery distributions. Similar anatomical variations are relatively common in the general population and may render some patients relatively and unpredictably more vulnerable to hypotension.
This article appears in the collection: Does beach-chair positioning increase the risk of stroke?.
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