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Canadian Journal of Anesthesia 53:738 (2006)
© Canadian Anesthesiologists' Society, 2006

Correspondence

Postoperative coma in a patient with complete basilar syndrome after anterior cervical discectomy

David P. Martin, MD PhD, Christopher J. Jankowski, MD, Mark T. Keegan, MB MRCPI and Laurence C. Torsher, MD FRCPC

Mayo Clinic College of Medicine, Rochester, USA, E-mail: martin.david{at}mayo.edu

To the Editor:

We applaud Tsai et al.,1 for drawing attention to the rare but devastating postoperative complication of basilar stroke. We would like to point out that proximate surgery in the neck may be coincidental rather than causative. In fact, we have reported a similar case that occurred after nephrectomy in which the cervical spine was not manipulated at all.2 Furthermore, we would like to suggest that consideration be given to early neuroradiologic or thrombolytic intervention, which may offer some chance to improve outcomes when basilar stroke is diagnosed early.3

Footnotes

Accepted for publication March 20, 2006.

References

1 Tsai YF, Doufas AG, Huang CS, Liou FC, Lin CM. Postoperative coma in a patient with complete basilar syndrome after anterior cervical discectomy. Can J Anesth 2006; 53: 202–7.[Abstract/Free Full Text]

2 Martin DP, Jankowski CJ, Keegan MT, Torsher LC. Postoperative confusion and basilar artery stroke. Neurocrit Care 2006; 4: 148–51.

3 Qureshi AI, Siddiqui AM, Suri MF, et al. Aggressive mechanical clot disruption and low-dose intra-arterial third-generation thrombolytic agent for ischemic stroke: a prospective study. Neurosurgery 2002; 51: 1319–27.[Medline]





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