PMC5115221_01
Schematic illustration of the patient's cardiovascular anatomy showing (
A) tricuspid atresia, (
B) transposition of the great arteries, (
C) atrial septum defect, (
D) ventricular septum defect, (
E) single-ventricle physiology, (
F) major aorto-pulmonary collateral arteries, and (
G) Blalock-Taussig shunt.. Copyright   2014 New Media Center, University of Basel. All Rights Reserved.
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A detailed illustration of the underlying cardiovascular anatomy is shown in Figure 1.
(
A) Contrast-enhanced computed tomography (CT) scan and (
B) gadolinium-enhanced magnetic resonance imaging (MRI) revealed a 2.7 x 2.9 x 3.2 cm ring-enhancing lesion within the right superior temporal gyrus with significant surrounding edema and a small area of central hemorrhage. (
C) Diffusion-weighted imaging (DWI) and (
D) apparent diffusion coefficient (ADC) MRI showed a diffusion-restricted core, supporting the differential diagnosis of acute cerebral abscess.
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Subsequent Gadolinium-enhanced magnetic resonance imaging supported the differential diagnosis of an acute intracerebral abscess ( Figure 2).
Intraoperative anesthesia record.. For fixation of the patient's head in the Mayfield frame, the target effect-site concentration (Cet) of propofol was temporarily increased to 1.0 microg ml
-1. Due to a subsequent brief loss of consciousness with upper airway obstruction, a short period of assisted bag-mask ventilation was performed. Adequate spontaneous respiration returned after the patient regained consciousness and was maintained throughout the procedure with supplemental oxygen delivery at 4 l min
-1 via nasal prongs (NB). Propofol and remifentanil infusions were adjusted to the patient's clinical level of sedation and pain and bispectral index monitoring. During surgery, the patient remained in cardiac sinus rhythm (SR) and hemodynamically stable without any need for vasopressor support.
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Relevant intraoperative events are shown in Figure 3.