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Early Recognition of a Transient Ischemic Attack Utilizing Cerebral Oxygenation Monitoring During Shoulder Surgery in the Beach Chair Position: A Case Report

Aguirre, José A. MD*; Mohajeri, Minou S. MMed cand.*; Rupnik, Barbara MD*; Brada, Muriel MMed*; Rosskopf, Andrea B. MD; Meyer, Dominik C. MD; Eichenberger, Urs MD*; Borgeat, Alain MD*

doi: 10.1213/XAA.0000000000001027
Case Reports

Shoulder surgery in the beach chair position is routinely performed, and central neurological events are rare but potentially devastating. We present a patient with transient neurological deficits after a sudden blood pressure drop with a simultaneous decrease of regional cerebral saturation values registered by cerebral oximetry. We reviewed published cases and proposed possible strategies to prevent the occurrence of similar complications in this context.

From *Anaesthesia, Intensive Care and Pain Medicine Department

Radiology, Balgrist University Hospital, Zurich, Switzerland

Orthopaedic Department, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

Accepted for publication March 18, 2019.

Funding: Support was provided solely by departmental sources.

The authors declare no conflicts of interest.

Address correspondence to Alain Borgeat, MD, Anaesthesia, Intensive Care and Pain Medicine Department, Balgrist University Hospital, Forchstrasse 340, 8008 Zürich, Switzerland. Address e-mail to

Copyright © 2019 International Anesthesia Research Society
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