Trigeminocardiac Reflex as a Complication of Excision of Schwannoma of the Trigeminal Nerve - A Rare Clinical Case Report

RATIONALE: Trigeminal schwannoma (TS) is a very rare tumour in the head-and-neck region and the occurrence of intraoperative trigeminocardiac reflex (TCR), during surgery, should not be underestimated. The physiological function of this rare brainstem reflex is yet to be fully established. PATIENT CONCERNS: TCR occurs in a variety of surgeries, such as neurosurgical, maxillofacial, dental and skull base surgeries with bradycardia as the presenting sign. DIAGNOSIS: This is a clinical profile of two patients who presented with schwannoma of the trigeminal nerve. OUTCOMES: Intraoperatively, during dissection of tumour, both patients had bradycardia with hypotension. TREATMENT: The first patient had a spontaneous recovery but the other required intervention with vasopressors. TAKE-AWAY LESSONS: One must be aware of the rare occurrence of TCR mainly while operating on a rare occurring TS. Ceaseless intraoperative monitoring and being prepared with adequate measures while manipulating close to the nerve will prevent serious complications.