Anesthetic management of an infant girl with cloverleaf syndrome
Kudoh, O.; Hanzawa, K.; Iwata, H.; Iizuka, H.; Suzuki, K.; Kugimiya, T.
Masui. Japanese Journal of Anesthesiology 55(10): 1273-1276
2006
ISSN/ISBN: 0021-4892 PMID: 17051994 Document Number: 599100
We experienced anesthetic management of an infant girl with Cloverleaf syndrome complicated with prenatal diagnosis of craniosynostosis. She received posterior-cranioplasty and foramen magnum decompression at the age of 44 days, ventricuro-peritoneal shunting at 80 days and cranioplasty at 149 days all under general anesthesia without serious complications. In all three occasions, we induced general anesthesia with oxygen, sevoflurane, nitrous oxide and thiopental with a facemask. After we made sure it was not impossible to maintain the airway and ventilation, we performed orotracheal intubation with vecuronium. We maintained anesthesia paying particular attention to intracranial pressure and possible massive hemorrhage particularly during cranioplasty. Postoperative course was uneventful. Anesthesiologists should keep in mind that this syndrome is characterized by severe skull deformity, facial bone abnormalities, hydrocephalus and increased intracranial pressure.