Unveiling what is absent within: illustrating anesthetic considerations in a patient with hydranencephaly – a case report

BACKGROUND: Hydranencephaly is a rare and debilitating congenital condition in which most anesthesiologists are unfamiliar. Primary surgical treatment involves CSF diversion, though other palliative procedures requiring anesthesia are often required. With medical advancements and a resulting prolonged life expectancy, caring for these patients is becoming more routine. CASE PRESENTATION: We follow an infant with hydranencephaly over three different procedures requiring anesthesia from 5 months of age to 2 years, highlighting the various anesthetic considerations. CONCLUSIONS: Anticipation of difficult positioning, deliberate airway management, and attention to anesthetic recovery were all necessary to safely care for this patient. An understanding of the challenges this particular condition poses will help anesthesiologists provide the most safe and effective care when encountering these patients.