Anaesthetic management in a patient with osteogenesis imperfecta undergoing craniotomy for subdural haemorrhage

Osteogenesis imperfecta (OI) is a genetic disorder of connective tissue in which bones fracture very easily, often for no apparent reason. The aetiology of the disease is a gene defect that produces very little or poor quality type 1 collagen, an important building block of bones.
Anaesthetic management is challenging because of the multi-organ system involvement in OI. Most notably, anaesthesiologists are challenged by a difficult airway, the fragile skeletal system during positioning, cardiovascular involvement, coagulation abnormalities and an association with malignant hyperthermia. We report successful anaesthetic management of an OI patient with a subdural haemorrhage associated with a road traffic accident who underwent craniotomy.