Trigeminal cardiac reflex in post-operative spheno-orbital meningioma
The Trigeminal Cardiac Reflex (TCR) is a phenomenon that is composed of bradycardia, arterial hypotension, apnoea, and gastric hypermobility. It mostly occurs during skull base surgery, at or around structures that are innervated by any sensory branch of the trigeminal nerve. We report a 48-year-old female who was diagnosed as having left spheno-orbital meningioma and had used a cranio-orbitozygomatic approach to remove the tumour. Six hours post-operatively, she had a sudden decrease in Heart Rate (HR), 31% decrease from baseline, and also a Mean Arterial Blood Pressure (MABP) decrease of 35% from baseline. Laboratory finding was normal, oxygen saturation was 100%, and no hyper- carbia occurred. She was suspected as having TCR. Intravenous administration of atropine abolished the reflex, and her HR and MABP slowly increased to normal.