Definition Coagulopathy is defined as a condition in which the blood’s ability to clot is impaired. Sometimes the term is used to represent both hypocoagulability and hypercoagulability. In this chapter we will be limiting our discussion primarily to hypocoagulability. Causes…
The inadvertent rupture of a vessel is not an uncommon complication during neurosurgical procedures. Other than major blood loss and its resultant complications, it carries a high risk of ischemia and permanent neurological deficits. This requires prompt management to minimize…
The utmost objective of anesthetic management of neurosurgical patients is the maintenance of adequate cerebral perfusion pressure (CPP) that prevents any secondary injury to the brain and spinal cord. Hemodynamic instability is often encountered intraoperatively or postoperatively and encompasses both…
Definition The close association between the brain and the heart makes the heart vulnerable during any neurologic insult. This may be reflected in the electrocardiogram (ECG) and could vary between sinus tachycardia to asystole (flat ECG). The abnormalities could be…
Definition Rupture of the intracranial aneurysm or an arteriovenous malformation during surgical clipping or coil embolization is one of the most devastating complications in neurosurgery. It is defined as a fresh or new leak in the existing vascular pathology occurring…
Postoperative paraplegia refers to new onset neurological deficit which occurs as a result of damage/insult to the spinal cord below T1 whereas quadriplegia/tetraplegia with or without respiratory dysfunction will occur when the insult is above the first thoracic vertebra. Usually…
Definition Seizure activities are not only difficult to diagnose intraoperative in an anesthetized patient; they are also less recognized clinically, as compared to postoperative seizures in the intensive care unit. Seizure activity may be evident only in cases of incomplete…
Definition Pneumocephalus is defined as an asymptomatic intracranial collection of air, commonly occurring after craniotomy or cranial burr hole. In a retrospective study, the incidence of intracranial air collection varied from 73% in park-bench position, 57% in prone position, and…
Definition Normal perfusion pressure breakthrough (NPPB) can be defined as the occurrence of multifocal areas of hemorrhage associated with unexplained cerebral edema after the resection of high-flow arteriovenous malformations (AVMs). Various theories have been proposed to explain the hemodynamic basis…
Definition Hydrocephalus (derived from Greek words hydros meaning water and cephalus meaning head) is defined as the excessive accumulation of cerebrospinal fluid (CSF) in the ventricular system and cisterns of the brain, leading to an increase in intracranial pressure (ICP)…