The Trigeminocardiac Reflex — An Example of Reflexive Heart Rhythm Change

The trigeminocardiac reflex (TCR) is defined as the sudden onset of parasympathetic dysrhythmia, sympathetic hypotension, apnoea or gastric hyper-motility during mechanical/thermal stimulation of any of the sensory branches of the trigeminal nerve. The risk factors that are already known for increasing the prevalence of the TCR include anatomical location, hypercapnia, hypoxemia, light general anaesthesia, age (more pronounced in children), the nature of the provoking stimulus (stimulus strength and duration) and different drugs. Already different potential confounders are also identified. This discussion about risk factors has its importance because of the substantial consequences for functional outcome after intraoperative TCR occurrence. But there remains still a substantial lack of thorough understanding of the TCR, the current treatment options for patients with TCR include a mostly empirical approach: (i) risk factor identification and modification; (ii) prophylactic measures of vital signs and (iii) administration of vagolytic agents or sympathomimetics. In this context, we have now created different thinking models so that we can preoperatively plan a skull base surgery procedure safely in relation to a potential occurrence of the TCR episodes. This chapter provides an overview of this unique reflex that presents a unique interaction between heart and brain. In addition, this also illustrates the mechanism of various cardiac rhythm changes related to the TCR

The role of acute trigemino-cardiac reflex in unusual, non-surgical cases: A mini-review

Trigemino-cardiac reflex is a well established phenomenon that is mainly reported in the various surgical specialities. However, the role of this unique reflex is entirely unknown in other medicine domains. Therefore, the present mini-review aims to explore the role of TCR in such unusual cases and also highlights the importance of case reports for knowledge creation in such context

The Trigemino-Cardiac Reflex: Beyond the Diving Reflex

The trigemino-cardiac reflex (TCR) is a well established brain-stem reflex and commonly manifests as bradycardia, asystole, hypotension and / or apnea. This phenomenon was extensively explored in the recent past. However, the area related to its exact bio-physiological mechanism, neuro-anatomical linkages, clinical implications, its role in non neurological events and future directions should need to be further investigated. Therefore, this present research topic on TCR would mainly focus on various aspects of TCR and present a comprehensive and exhaustive overview about a phenomena that gains more and more interest during the last few years. Our goal is to present models about the different aspects of the TCR to develop in-depth understanding of TCR