40.1 Anesthesia: safety, comfort, and facilitation of the procedure The anesthesiologist is a key member of the team conducting the intraoperative neurophysiology (ION), whether the monitoring is surgical in the operating room, or procedures such as neurovascular embolization, in the…
Introduction Monitoring of the central nervous system using evoked responses allows assessment of neural tracts that are normally silent during coma or anesthesia. This differs from the electroencephalogram (EEG), which monitors spontaneous activity. They are not a replacement for awake…
Risk Highest incidence age is 3–12 y and 55–65 y. Account for 80% of adult CNS tumors; incidence of primary tumor is ∼15–20:100,000 per y. Account for one-third of childhood CNS tumors. Perioperative Risks Increased ICP: Headache, seizures, neurologic deficit/dementia,…
Risk Highest incidence: Age 3–12 y and 55–65 y Two-thirds of childhood CNS tumors; approximately 3–5:100,000/y under age 19 y 15–20% of adult CNS tumors; incidence lower than in children Perioperative Risks Very confined space, brain tolerates tumor poorly, leading…
Case Synopsis A 32-year-old man presents to the emergency department following a motorcycle accident in which he was thrown to the roadside. He is mildly obtunded, smells of alcohol, and is difficult to examine neurologically, but he appears to have…