Postoperative sudden cardiac arrest after craniotomy with tumor removal in prone position: Massive pulmonary embolism

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Supitcha Chantakul


Background: A Thai 46-year-old woman with
essential hypertension was diagnosed right
cerebellopontine angle meningioma. She underwent
craniotomy with tumor removal under general
anesthesia with endotracheal tube intubation in
prone position for 11 hours. After the operation,
she was turned to supine position and the
electrocardiogram showed pulseless electrical
activity (PEA). CPR was done about 5 minutes and
the spontaneous circulation returned. At the ICU,
echocardiogram showed dilated right ventricle.
The computed tomography angiography (CTA) of
pulmonary artery showed massive pulmonary
embolisms in both main pulmonary arteries. She
was transferred to cardiac center and she was treated
by intralesional recombinant tissue plasminogen
activator (rtPA) injection. Finally, she could be
discharged with fully recovery.

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Case reports


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