Asymmetry of the bilateral bispectral index in a hemiparetic patient with porencephaly

In patients with porencephaly, it may be erroneous to adjust the level of anesthesia based entirely on the BIS value, and it has previously been suggested that the anesthetic depth should instead be judged on unilateral BIS monitoring [1]. [...]we performed bilateral BIS monitoring in the present case. In a previous study that used single photon emission computed tomography to evaluate the rCBF distribution in patients with brain malformations under closed-eyes, non-anesthetized conditions, a patient with porencephaly showed severely decreased rCBF in the abnormal cortex with gliosis [4]. [...]in patients with porencephaly, it is advisable to titrate the anesthetic depth using bilateral BIS monitoring to ensure the safety of anesthesia.Disclosures None.Conflict of interest None.Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Acknowledgment We thank Dr. Kelly Zammit, BVSc, from Edanz Editing (www.edanzediting.com/ac), for editing a draft of this manuscript.