Deep hypothermia with circulatory arrest has been successfully used on patients where conventional surgical techniques and endovascular techniques have not been the best alternative and where the concurrence of a multidisciplinary group was essential for providing attention for this patient and resolving her pathology. 1. Mack WJ, Ducruet AF, Angevine PD, Komotar RJ, Shrebnick DB, Edwards NM, Smith CR, Heyer EJ, Monyero L, Connolly ES Jr, Solomon RA. Deep hypothermia and Circulatory Arrest for Surgery of Complex Intracranial Aneurysms: Lassons Learned. Neurosurgery. 2008; 62 Suppl 3:1311-23. 2. Young WL et al. Anesthetic Management of Deep Hypothermic Circulatory Arrest for Cerebral Aneurysm Clipping. Anesthesiology. 2002; 96: 497-503. 3. Massad MG et al. Closed Chest Hypothermic Circulatory Arrest for Complex Intracranial Aneurysms. Society of Thoracic Surgeons. 2001; 71: 1900-4. 4. Dewitte TC III. Endovascular Treatment of Cerebral Aneurysms Will Replace Clipping. Journal of Neurosurgical Anesthesiology. 2003; 15: 58-60. 5. Chicoine MR. Microsurgery and Clipping: The gold standard for Treatment of Intracranial Aneurysms. Journal of Neurosurgical Anesthesiology. 2003; 15: 61-3. 6. Morita KI, Inenaga C, Ito Y, Fujii Y et al. An Autopsy Case Of Gigant Aneurism of vertebrobasilar artery treated endovascular surgery. Acta Neurochirúrgica. 2003; 145: 723-5. 10. Aebert H et al. Deep hypothermia and Circulatory Arrest for Surgery of Complex Intracranial Aneurysms. Cardio-Thoracic Surgery. 1998; 13; 223-9. 11. Hacein-Bey L, Connolly ES Jr, Mayer SA et al. Complex intracranial aneurysms: combined operative and endovascular approaches. Neurosurgery. 1998; 43:1304-12. 12. Drake CG, Barr HWK, Coles JC et al. The use of extracorporeal circulation and profound hypothermia in the treatment of ruptured intracranial aneurysm. J Neurosurg. 1964; 21:575-81. 13. Baumgartner WA, Silverberg GD, Ream AK et al. Reappraisal of cardiopulmonary bypass with deep hypothermia and circulatory arrest for complex neurosurgical operations. Surgery. 1983; 94:242-9. 14. Thomas AN, Anderton JM, Harper NJ. Anaesthesia for the treatment of a giant cerebral aneurysm under hypothermic circulatory arrest. 1990; Anaesthesia.45:383-5. 15. Spetzler RF, Hadley MN, Rigamonti D et al. Aneurysms of the basilar artery treated with circulatory arrest, hypothermia, and barbiturate cerebral protection. J Neurosurg. 1988; 68:868-79. 16. Young WL, Lawton MT, Gupta DK, et al. Anesthetic management of deep hypothermic circulatory arrest for cerebral aneurysm clipping. Anesthesiology. 2002; 96:497-503. 17. Nussmeier NA, Arlund C, Slogoff S. Neuropsychiatric complications after cardiopulmonary bypass: cerebral protection by a barbiturate. Anesthesiology. 1986; 64:165-70. 18. Kahveci FS, Kahveci N, Alkan T et al. Propofol versus isoflurane anesthesia under hypothermic conditions: effects on intracranial pressure and local cerebral blood flow after diffuse traumatic Brain injury in the rat. Surg Neurol. 2001; 56:206-14. 19. Hindman BJ, Todd MM, Gelb AW et al. Mild hypothermia as a protective therapy during intracranial aneurysm surgery: a randomized prospective pilot trial. Neurosurgery. 1999; 44:23-32. 21. Johnston SC, Wilson CB, Halbach VV et al. Endovascular and surgical treatment of unruptured cerebral aneurysms: comparison of risks. Ann Neurol. 2000; 48:11-9. 22. Lai YC, Manninen PH. Anesthesia for cerebral aneurysms: a comparison between interventional neuroradiology and surgery. Can J Anaesth. 2001;48: 391-5.
La hipotermia profunda con paro circulatorio se utilizó exitosamente en el caso de la paciente aquí reportado, en donde las técnicas quirúrgicas convencionales y las técnicas endovasculares no eran la mejor alternativa, y en donde el concurso de un grupo multidisciplinario fue esencial para poder brindar atención y solución a la patología de la paciente.