Anaesthetic management of occipitocervical stabilization and C1–C3 decompression in a patient with intradural cervical tumor and prior stroke: A case report

• Author Details:   
• Amrapali Naik
• Naba Mateen Madoo ^*

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Upper cervical spinal surgeries pose significant anaesthetic challenges due to proximity to the brainstem, potential for spinal cord compromise, and the need for advanced airway management. These challenges are further compounded in patients with underlying neurological or pulmonary comorbidities. We report the anaesthetic management of a 64-year-old male with a history of cerebrovascular accident (CVA), chronic smoking, and newly diagnosed hypertension, who presented with a C1–C3 intradural spinal tumor and underwent occipitocervical stabilization and decompression. This case emphasizes key considerations including airway assessment, respiratory optimization, hemodynamic stability, intraoperative neuromonitoring, and perioperative temperature and fluid management. Total intravenous anaesthesia (TIVA) with propofol and dexmedetomidine enabled reliable motor and somatosensory evoked potential monitoring. A multidisciplinary approach, along with meticulous intraoperative repositioning from prone to lateral, was critical to minimize the risk of neurological and airway complications.