title: [Anesthetic management of an infant girl with cloverleaf syndrome].
abstract: We experienced anesthetic management of an infant girl with Cloverleaf syndrome complicated with prenatal diagnosis of craniosynostosis. She received posterior-cranioplasty and foramen magnum decompression at the age of 44 days, ventricuro-peritoneal shunting at 80 days and cranioplasty at 149 days all under general anesthesia without serious complications. In all three occasions, we induced general anesthesia with oxygen, sevoflurane, nitrous oxide and thiopental with a facemask. After we made sure it was not impossible to maintain the airway and ventilation, we performed orotracheal intubation with vecuronium. We maintained anesthesia paying particular attention to intracranial pressure and possible massive hemorrhage particularly during cranioplasty. Postoperative course was uneventful. Anesthesiologists should keep in mind that this syndrome is characterized by severe skull deformity, facial bone abnormalities, hydrocephalus and increased intracranial pressure.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Juntendo University School ofMedicine, Tokyo 113-8421.
authors.forename: Osamu
authors.initials: O
authors.lastname: Kudoh
authors.forename: Koichi
authors.initials: K
authors.lastname: Hanzawa
authors.forename: Hitomi
authors.initials: H
authors.lastname: Iwata
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Iizuka
authors.forename: Keiko
authors.initials: K
authors.lastname: Suzuki
authors.forename: Toyoki
authors.initials: T
authors.lastname: Kugimiya
mesh_terms: D000015:Abnormalities, Multiple; D000768:Anesthesia, General; D003398:Craniosynostoses / Q000601:surgery*; D019299:Decompression, Surgical; D005145:Face / Q000002:abnormalities*; D005260:Female; D005539:Foramen Magnum / Q000601:surgery; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D007223:Infant; D007427:Intracranial Pressure; D007430:Intraoperative Care; D007442:Intubation, Intratracheal / Q000379:methods; D012886:Skull / Q000002:abnormalities* / Q000601:surgery*; D013577:Syndrome; D017287:Ventriculoperitoneal Shunt