Anesthetic considerations for intraoperative management of cerebrovascular disease in neurovascular surgical procedures.
Despite new surgical methods and interventions a considerable number of patients who undergo neurovascular procedures emergently or electively have substantial mortality, morbidity, and disability. Sound knowledge of pathophysiology of cerebral hypoperfusion, reliable and timely information from monitoring devices, and appropriate choice of therapeutic intervention is essential for successful anesthetic management of these patients. The management of perioperative vasospasm and temporary ischemia during aneurysm clipping require an understanding of cerebral vascular pathophysiology and neuroprotective measures.
Avitsian
Rafi
R
Department of General Anesthesiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. avitsir@ccf.org
Schubert
Armin
A
D000768:Anesthesia, General; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000792:Angiography; D001921:Brain / Q000033:anatomy & histology / Q000378:metabolism / Q000502:physiology; D002561:Cerebrovascular Disorders / Q000601:surgery*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000145:classification / Q000150:complications / Q000601:surgery; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods; D013525:Surgical Instruments; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous