Postoperative Hyperglycemia with Ketosis Sans Acidemia in a Child Immediately Following Fourth Ventricular Medulloblastoma Resection: Anesthetic Concerns and Intensive Care Management

Postoperative hyperglycemia with ketosis immediately following fourth ventricular medulloblastoma surgery for a non-diabetic child with normal intraoperative blood glucose, is an uncommon clinical entity, and has seldom been reported in the literature. We present the management of this rare complication in a child. Surgical manipulation in and around the fourth ventricle and brainstem region may have disrupted central energy metabolic control involving the brain-islet axis, leading to impaired glucose homeostasis. Tumor's molecular characteristics may have also contributed to altered glucose metabolism. We emphasize the importance of being aware of this rare complication for their safe management.