title: Anesthesia and concussion.
abstract: OBJECTIVE
  As clinicians preparing patients for general anesthesia, should we consider the possibility of concussion in our elective operative patients? If so, why is this necessary? Is it possible that exposure to an anesthetic is detrimental to recovery from concussion? If so, what should we do about the imperative/urgency for surgery? No answers are promised in this review. Rather, the focus is on the questions and approaches taken in the recent literature, as well as highlighting a need for more research.
  
  
  RESULTS
  Surgery, pain and general anesthesia all influence autonomic nervous system responses. Intravenous and inhalational anesthetic agents are also known to have variable effects on the cerebrovascular reactivity (CVR) to carbon dioxide (CO2). This review adds to this general information the recent, specific physiologic alterations seen after concussion in autonomic system function and the CVR to CO2.
  
  
  CONCLUSIONS
  This review provides a perspective about autonomic nervous system function and cerebrovascular effects of concussion, and some relevant clinical issues that warrant further clinical study.
authors.affiliation: aDepartment of Neurology bDivision of Critical Care Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Tasker
mesh_terms: D000293:Adolescent; D000768:Anesthesia, General / Q000009:adverse effects* / Q000379:methods; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000009:adverse effects; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging*; D001924:Brain Concussion / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002245:Carbon Dioxide / Q000009:adverse effects; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D002648:Child; D006801:Humans; D008279:Magnetic Resonance Imaging; D013514:Surgical Procedures, Operative / Q000009:adverse effects
chemical_list: D018685:Anesthetics, Inhalation; D002245:Carbon Dioxide