Anaesthetic Management of a Case of Parkinson’s Disease with Extradural Haematoma and Atrial Flutter Posted for Emergency Craniotomy

Abstract

Parkinson’s Disease (PD) patients are more prone to traumatic injury due to a short shuffling gait and skeletal muscle rigidity. Diabetes mellitus is a chronic metabolic syndrome that affects all vital systems, including the autonomic nervous system. Cardiac autonomic neuropathy affects the conducting system of the heart, producing cardiac arrhythmias and silent ischaemia. Here, the authors report a case of head injury with Extradural Haematoma (EDH) in a 81 year old geriatric male patient posted for EDH evacuation. Emergency craniotomy in this patient with pre-existing PD, diabetes mellitus, and new-onset atrial flutter presents a significant challenge in anaesthetic management. In addition to that, chronic alcoholism further necessitates the selection of appropriate anaesthetic techniques and vigilant perioperative management to prevent intraoperative cardiac arrhythmias, hypotension, heart failure, and pulmonary oedema.

Keywords

• atrial arrhythmias
• autonomic dysfunction
• diabetes mellitus
• head injury
• perioperative complication