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The Virtual Anaesthesia Textbook

Anaesthesia for Neurosurgery

Last modified 9/11/2014. Comments to: Chris Thompson

Contents:


NeuroAnaesthesia Web Sites

The Society for Neurosurgical Anaesthesia and Critical Care (SNACC) web page has a comprehensive bibliography (requires membership, but with direct PubMed links).


Basic Science

Roger Traill has provided some notes on neurophysiology.

Neurological Examination (and for paediatrics) Detailed techniques from the University of Utah wih video. Others from Toronto and neuroexam.com

For neuroanatomy check out the Harvard Brain Atlas a huge listing of brain images, including indications of functional deficits - very comprehensive.

Chris Thompson's annotated slides on cerebral protection might be of interest if you do carotids.

To optimise emergence after prolonged anaesthesia, drug administration must be optimal. See Chris Thompson's detailed look at context sensitive decrement times.


Handbooks

Cleveland Waterman & GasNet Neuroanesthesia Manual


Techniques

TransCranial Doppler - a basic summary of TCD by Stefan Strebel, University of Basel.

Notes from Roger Traill on hypotensive agents in neurosurgery, an EEG & EP primer (from the NeuroTrac manual).


Clinical Issues

Pre-operative Evaluation of the Neuro Patient, haemodynamic and electophysiological monitoring, by Roger Traill.

Anaesthesia for Interventional Radiology - 4 part series by A. Rosas MD, from the Internet Journal of Anesthesiology. Part 1 Part 2 Part 3 Part 4. Notes on MRI Anaesthesia by Roger Traill.

Carotid Endarterectomy - Cochrane Review of local vs. general anaesthesia; MGH update on current management issues, see the chapter on regional anaesthesia, stenting vs endarterectomy BJA 2010 Cole, notes from Roger Traill, and BHJ case report with discussion. Chris Thompson's annotated slides on cerebral protection might be of interest.

Neurosurgical Anaesthetic Emergencies, by Roger Traill.

Cerebral aneurysms - surgical notes from Michael Morgan. Advice from the Aneurysm & AVM Support Group. Notes on anaesthesia for aneurysms by Roger Traill.

AVM's - patient info notes from Michael Morgan, advice from the Aneurysm & AVM Support Group.

Paediatric Neurosurgery - Columbia. General info on paediatric neurosurgical problems, aimed at patients, but a useful pathology summary none the less.

Acute Head Injury - secure the airway if respiration is obstructed or weak (always consider the possibility of an unstable fractured neck), hyperventilation for acute elevations of ICP is acceptable for periods of up to a few hours, give mannitol if ICP elevation is not corrected by adequate ventilation, maintain an adequate blood pressure (aim for a mean of at least 50 above ICP), avoid nitrous oxide. If you can't measure ICP assume that it is high. The pupils only blow when things are really bad. Get a CT scan and then definitive treatment as soon as possible. Notes on the anaesthetic manaement of acute head injuries, by Roger Traill.

Spinal injuries - PJ Corke


Case Reports

The Effects of Laryngeal Mask Insertion on Intracranial Pressure in a Patient with Posterior Fossa Tumor D. Ferson, M.D.


Link to VAT

visitors to this chapter since April 29th 2000.

Original concept for the Virtual Anaesthesia Textbook by:
Dr. Chris Thompson
Senior Staff Specialist Anaesthetist
Royal Prince Alfred Hospital
Sydney Australia