Posterior Fossa Bradycardia — FRCA Final MCQ

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ModerateNeuroanaesthesiaPosterior Fossa BradycardiaFRCA Final

During posterior fossa craniotomy: acute bradycardia to 30 bpm. Most likely cause specific to this location?

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Correct answer: A — Direct brainstem manipulation — trigeminovagal reflex

Direct brainstem manipulation (floor of 4th ventricle, nucleus tractus solitarius) triggers vagal bradycardia → possible asystole. Immediate: inform surgeon to stop, atropine 600 mcg IV. Most common bradycardia cause specific to posterior fossa.

Reference: SBNS/RCOA – 2023 – Posterior fossa surgery complications