A 5-Year-Old With a History of “Feeling Walls” and Nocturia for Resection of a Suprasellar Tumor

Abstract

Abstract Introduction This narrative problem-based learning module is designed to facilitate group discussion with the integration of clinical knowledge and self-directed learning. It addresses a complex situation involving a child with a suprasellar mass requiring imaging and surgical resection. It also addresses the issue of delayed emergence following neurosurgery, as well as the differential diagnosis of postoperative hyponatremia, which is common in these settings and often presents a diagnostic dilemma. Methods After a case presentation, the instructor guides the group through a series of questions, each of which promotes discussion and reviews the available data on the subject. The module is formatted as one 2-hour session, but it can also be implemented as two 1-hour sessions, depending on time available. The module was developed based on the authors' personal experience with a similar situation and a subsequent literature search on the issues covered in the module. Selected references were added to the bibliography to enhance the learner experience and highlight current evidence to support the management options presented in the discussion. Results This module was developed for use at the 2006 and 2008 American Society of Anesthesiologists Annual Meetings and was presented twice to learners (residents, anesthesiology faculty in academic practices, and private practice anesthesiologists) at each meeting. It was also utilized with pediatric anesthesiology fellows at the primary author's institution. The module received positive feedback from both conference attendees and pediatric anesthesiology fellows. Discussion The module can easily be incorporated into a residency, fellowship, or CME curriculum. Although the module features a pediatric patient, many adult providers care for teenage patients and would be able to actively participate in the discussion and be engaged with the clinical issues.

Keywords

• Anesthesia
• Diabetes Insipidus
• Sedation
• Magnetic Resonance Imaging
• MRI
• Hyponatremia