Postoperative neurological deficit in a pediatric patient with an undiagnosed arachnoid cyst after combined anesthesia: Case report

Abstract

Introduction
Arachnoid cysts are the most
common intracranial cystic lesions in the pediatric
population Many remain asymptomatic and are
diagnosed incidentally via neuroimaging studies
Case report We present the case of a 3 year old
male patient who underwent balanced general
anesthesia combined with a subarachnoid block,
with no apparent intraoperative incidents In the
post anesthesia care unit ( he exhibited
respiratory depression and bradycardia which
responded to initial resuscitation maneuvers
Subsequently he continued to show drowsiness
and fluctuating levels of consciousness a
computed tomography ( scan was therefore
requested revealing a lesion consistent with an
intracranial arachnoid cyst Discussion Arachnoid
cysts may remain clinically undetected in pediatric
patients and manifest during the perioperative
period with nonspecific neurological symptoms A
targeted patient history and clinical suspicion in
the face of an atypical postoperative course can
guide the diagnosis The significance of this case
lies in the temporal association between general
anesthesia spinal anesthesia and a postoperative
neurological event while direct causality is not
established the case highlights the importance of
a targeted neurological history monitoring in the
PACU, and a timely multidisciplinary approach.