[Cerebral infarction associated with esophagectomy: a report of a case].
We report a case of cerebral infarction developed either during or immediately after an operation. A 71-year-old man with esophageal cancer and a history of hypertension and asymptomatic cerebral infarction underwent right thoracolaparotomy for a subtotal esophagectomy. Anesthesia was maintained with a combination of 2% sevoflurane in oxygen and epidural analgesia using 2% mepivacaine. The operation was uneventful and the patient was transferred to ICU with the tracheal tube in place. On removal of the tracheal tube the next day the patient was unable to speak and his grip power of the right hand was weak. On CT a cerebral infarction was found in the left frontal lobe. A left carotid echogram showed a 90% constriction. The occlusion of the middle cerebral artery by an embolus detached from the constricted origin of the carotid artery was thought a most probable cause of the cerebral infarction. The presence of a carotid constriction must be explored preoperatively in aged patients scheduled to undergo extensive manipulations in the neck
Yoshioka
Masatomo
M
Department of Anesthesiology, Yamagata Prefectual Central Hospital, Yamagata.
Matsushita
Sachiko
S
Nunokawa
Hiroko
H
Yamakawa
Mikiko
M
Kagami
Isao
I
D000368:Aged; D002544:Cerebral Infarction / Q000209:etiology*; D016629:Esophagectomy; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D011183:Postoperative Complications