{"id":"38d5d563-ff6d-4762-96c9-0003514d4326","slug":"brain-death-after-concorde-positioning-for-supracerebellar-infratentorial-approach-unanswered-questions-and-lessons-learned","title":"Brain death after Concorde positioning for supracerebellar–infratentorial approach: Unanswered questions and lessons learned","authors":["Ashish Kumar","Suchanda Bhattacharjee","Barada P. Sahu","Dilip Kulkarni"],"abstract":"Background: This article presents a case of a 51-year-old male who developed brain death following a supracerebellar–infratentorial approach for a pineal region tumor. The patient exhibited severe headache and vomiting prior to surgery, with imaging revealing a hyperdense lesion and moderate hydrocephalus. Despite an uneventful surgical procedure, the patient did not regain consciousness postoperatively. Methods: The patient was positioned in the Concorde position after induction of general anesthesia, with careful monitoring of airway pressures. A vertical midline incision was made, and the surgery proceeded with the intention of gross total removal of the tumor. Postoperative imaging was conducted to assess any complications. Results: Postoperative MRI revealed significant white matter changes and ischemic changes in the brainstem, leading to the patient's rapid decline in neurological status. Despite initial hemodynamic stability, the patient was declared brain dead within 12 hours of surgery after showing no signs of recovery. Conclusion: This case highlights the potential risks associated with the Concorde position during neurosurgery, particularly regarding cervical stability and venous drainage. The authors emphasize the necessity of preoperative assessments and neurophysiological monitoring to mitigate such risks in future surgeries. Keywords: brain death, Concorde position, supracerebellar-infratentorial, neurosurgery, venous infarct, cervical instability, postoperative complications","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/38d5d563-ff6d-4762-96c9-0003514d4326/featured/hero-1782421016313.png","publishDate":"2012-03-19T00:00:00.000Z","doi":"10.4103/2152-7806.94036","categories":["Original Article"],"fullTextUrl":"http://sni.wpengine.com/wp-content/uploads/2015/05/3323/SNI-3-37.pdf"}