뇌수막종 제거 시 발생한 Gasserian ganglion 형 삼차신경 심반사 - 증례보고 -

The trigeminocardiac reflex (TCR) is defined as sudden onset of parasympathetic dysrhythmia, mean arterial blood pressure change, apnea, or gastric hypermotility during stimulation of any branches of the trigeminal nerve. Clinical presentation of TCR is varied according to three subtypes, which are central, peripheral and Gasserian ganglion type. Gasserian ganglion type is rarely reported and caused by direct stimulation around the Gasserian ganglion. A 61-year-old female with meningioma around the trigeminal nerve was scheduled for meningioma removal. Unexpected severe bradycardia and hypertension happened when the surgeon manipulate the mass around Gasserian ganglion in the Meckel's cave. Gasserian ganglion type TCR was suspected and hemodynamic changes were stabilized after discontinuation of surgical manipulation and atropine injection. After that, the patient repeatedly showed severe bradycardia every mass manipulation, and surgeon decided to end the operation after only partial mass resection. The patient was discharged on the 12th postoperative day without any complications.