摘要
To the Editor： Here we report a craniotomy under general anesthesia successfully performed at a 4350-m altitude and the patient＇s follow-up results. To the best of our knowledge, this is one craniotomy carried out at the highest altitude in the world to date.A 21-year-old man occurred spontaneous light headache in the Ali area at a 4350-m altitude in the Tibet autonomous region of China on October 23,2011, and his headache became severe gradually. Three days later, the patient was in a coma with 5 scores （E1V1M3） on the Glasgow Coma Scale （GCS）; his left pupil diameter was 5.0 mm and right pupil diameter was 3.0 ram, both direct and indirect light reflex of the bilateral pupils disappeared. Craniocerebral computed tomography （CT） scan indicated a large acute subdural hematoma located in the left fronto-temporo-parietal region, widespread subarachnoid hemorrhage and brain herniation [Figure l a-c]. Emergency treatment was given for the patient in time, including continuous mask oxygen inhalation, strong dehydration （20% mannitol 250 ml ＋ furosemide 10 mg ＋ dexamethasone 5 rag, fast intravenous drip, once per 5 h）, and medical hemostasis.
To the Editor： Here we report a craniotomy under general anesthesia successfully performed at a 4350-m altitude and the patient＇s follow-up results. To the best of our knowledge, this is one craniotomy carried out at the highest altitude in the world to date.A 21-year-old man occurred spontaneous light headache in the Ali area at a 4350-m altitude in the Tibet autonomous region of China on October 23,2011, and his headache became severe gradually. Three days later, the patient was in a coma with 5 scores （E1V1M3） on the Glasgow Coma Scale （GCS）; his left pupil diameter was 5.0 mm and right pupil diameter was 3.0 ram, both direct and indirect light reflex of the bilateral pupils disappeared. Craniocerebral computed tomography （CT） scan indicated a large acute subdural hematoma located in the left fronto-temporo-parietal region, widespread subarachnoid hemorrhage and brain herniation [Figure l a-c]. Emergency treatment was given for the patient in time, including continuous mask oxygen inhalation, strong dehydration （20% mannitol 250 ml ＋ furosemide 10 mg ＋ dexamethasone 5 rag, fast intravenous drip, once per 5 h）, and medical hemostasis.
基金
This study was supported by a grant from the National Natural Science Foundation of China
