Fluctuating Decision-Making Capacity in a Patient with Subarachnoid Hemorrhage Presenting for Airway Intervention

Authors

• Gabrielle Gappy, Oakland University William Beaumont School of Medicine Medical Student
• Amanda Herrera, Corewell Health East Resident
• Roy Soto, Corewell Health East

Document Type

Conference Proceeding

Publication Date

10-18-2026

Abstract

A 59-year-old female with a brain aneurysm and secondary subarachnoid hemorrhage (SAH) requiring ventriculoperitoneal shunt placement developed symptomatic tracheal stenosis requiring direct laryngoscopy under general anesthesia. During her hospital course, she demonstrated fluctuating levels of cognition, which complicated preoperative assessment of decision-making capacity. There was no surrogate decision-maker documentation available. Additionally, the high-risk nature of the procedure from an anesthetic standpoint, as jet-ventilation techniques were to be used, amplifies the importance of patient understanding and informed consent. This case highlights the distinction between orientation and decision-making capacity, and demonstrates the vital role an anesthesiologist often plays in assessing informed consent.

Comments

American Society of Anesthesiologists, The Anesthesiology Meeting, October 16-20, 2026, San Diego, CA

Recommended Citation

Gappy G, Herrera A, Soto R. Fluctuating decision-making capacity in a patient with subarachnoid hemorrhage presenting for airway intervention. Presented at: American Society of Anesthesiologists, The Anesthesiology Meeting; 2026 Oct 18; San Diego, CA. Available from: https://www.abstractsonline.com/pp8/#!/21448/presentation/9204