Anesthesia for Neurosurgical Emergencies

Shilpa Rao; Rafi Avitsian

doi:10.1016/j.anclin.2019.10.004

Anesthesia for Neurosurgical Emergencies

Anesthesiol Clin. 2020 Mar;38(1):67-83. doi: 10.1016/j.anclin.2019.10.004.

Authors

Shilpa Rao¹, Rafi Avitsian²

Affiliations

¹ Department of Anesthesiology, Yale School of Medicine and Yale New Haven Hospital, 333 Cedar Street, TMP 3, PO Box 208051, New Haven, CT 06520-8051, USA. Electronic address: Shilpa.rao@yale.edu.
² Department of General Anesthesiology, Cleveland Clinic Foundation, 9500 Euclid Avenue # E31, Cleveland, OH 44195, USA.

PMID: 32008658
DOI: 10.1016/j.anclin.2019.10.004

Abstract

Neurosurgical procedures are unique in that the best monitoring modality is the neurologic examination and the most important sign includes an intact mental status. Anesthesiologists play a vital role in medical management of neurosurgical emergencies. The authors discuss the important management strategies for these emergencies, including increased intracranial pressure and impending brain herniation, acute alteration of mental status, status epilepticus, and trauma to cervical spine. The key is to maintain cerebral and spinal cord perfusion pressure at all times to salvage neuronal recovery.

Keywords: Cerebral perfusion pressure; Intracranial pressure; Seizure management; Trauma to spine.

Publication types

Review

MeSH terms

Anesthesia / methods*
Anesthesiologists
Anticoagulants / therapeutic use
Carotid Stenosis / surgery
Catheterization, Central Venous
Emergencies*
Humans
Intracranial Aneurysm / surgery
Intracranial Pressure
Monitoring, Intraoperative
Neurosurgical Procedures / methods*
Stroke / surgery

Substances

Anticoagulants