Mannitol is one of the indispensable drugs in neurosurgery to manage the raised intracranial pressure. Though considered safe, extravasation of mannitol into the tissues can cause considerable morbidity with the consequent development of compartment syndrome. We report a case of a 50-year-old female who developed forearm compartment syndrome due to mannitol extravasation after undergoing surgery for frontal glioma under general anaesthesia. The severe forearm compartment syndrome could be successfully managed without fasciotomy using hyaluronidase. We describe the pathophysiology, prevention and treatment strategies emphasising the use of hyaluronidase in the management of mannitol extravasation induced compartment syndrome.
Keywords: Mannitol extravasation, compartment syndrome, hyaluronidase, neuroanaesthesia, glioma