Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

article i nfo Article history: The trigeminocardiac refl ex (TCR) is defined as a reproducible hypotension and bradycardia coinciding with the manipulation around the trigeminal nerve. Here, we report a case of sudden bradycardia with falcine manipulation. As the falx cerebri is innervated by the nervus tentorii, which is a recurrent branch of the ophthalmic nerve, the observed asystole is highly possible to be caused by TCR. Anesthesiologists and neurosurgeons should be fully aware of the anatomical innervation of the falx cerebri and that the posterior third of the falx cerebri is one of the highest risk structures for TCR induction for safe operation around this region. © 2014The Authors. Published by Elsevier B.V. Thisisanopenaccess article underthe CC BY-NC-SA license