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Pituitary Apoplexy
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Neuroendocrine Lesions
The neuroendocrine system is responsible for the maintenance of milieu interior and facilitation of reproduction through secretion of various hormones. These hormones are regulated by interactions and feedback loops between the central nervous system, the endocrine glands, and the target…
Flow Arrest in Cerebrovascular Surgery
Deep Hypothermic Circulatory Arrest Historical Use of Hypothermic Circulatory Arrest in Neuroanesthesia In 1955, Lougheed et al. demonstrated that cerebral injury due to anoxia from arrest of cerebral circulation in animals could be reduced under hypothermic conditions. In the same year,…
Cerebrovascular Disease
Intracerebral Hemorrhage Intracerebral hemorrhage (ICH) is an important and common cause of stroke, which has the most devastating consequences. It is characterized by abrupt onset of severe headache, altered level of consciousness, or focal neurological deficit associated with focal collection…
Circulatory Arrest
Introduction Despite the advent of novel endovascular options and the advancement of microsurgical techniques and instruments, a small subset of intracranial aneurysms present a challenge to the neurovascular practitioner. Intracranial aneurysms of large or giant dimensions may be difficult to…
Aneurysmal Subarachnoid Hemorrhage
History History of subarachnoid hemorrhage (SAH) dates back to Byrom Bramwell, who first described the symptoms of spontaneous meningeal hemorrhage. The term “spontaneous subarachnoid hemorrhage” was coined in 1924 by Charles P. Symonds. Successful clipping of internal carotid artery (ICA)…
Refractory Status Epilepticus
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Anesthesia for Epilepsy Surgery
Introduction Epilepsy is a clinical brain disorder characterized predominantly by paroxysmal recurring seizures. The International League Against Epilepsy (ILAE) proposed the definition as a “disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the…
Transesophageal Echocardiography
Introduction The ability to visualize the chambers of the heart during neurosurgical procedures provides the anesthesiologist with data regarding cardiac function, valvular abnormalities, and presence or absence of intracardiac shunts; helps to visualize intracardiac extraneous material such as clots and…
Anesthesia for Posterior Fossa Surgery
Introduction Posterior fossa surgery poses significant challenges to both the anesthesiologist and surgeons with a wider variety of complications than surgery in the supratentorial compartment. Apart from the general perioperative considerations involving any intracranial lesion, highlights of posterior fossa lesions…