Sitting Position During Surgery
FIGURE 21.1 A: Sagittal MRI of the brain with gadolinium demonstrating large pineal region mass compressing the tectal plate and effacing the posterior third ventricle. B: Sagittal MRI following sitting…
Brain Metabolism, Cerebral Blood Flow, and Cerebrospinal Fluid
In humans, using nuclear magnetic resonance spectroscopy (MRS), lactate contribution to brain energy metabolism was reported to be less than 10% under basal conditions. However, this increased to as much…
Carotid Endarterectomy
FIGURE 7.1 Carotid plaque. (Courtesy of Dr. Ed. Uthman, MD) FIGURE 7.2 Cerebral autoregulation. (Reused from Kincaid MS, Lam AM. Anesthesia for neurosurgery. In: Barash PG, Cullen BF, Stoelting RK,…
Other Monitoring Techniques: Jugular Venous Bulb, Transcranial Doppler, and Brain Tissue Oxygen Monitoring
FIGURE 28.1 jVO2 flow chart. 2. Elevated SjVO2 is a marker of either luxuriant blood flow (or hyperemia) or diminished ability of the brain tissue to extract oxygen. Hyperemia is…
Neurosurgery in the Pregnant Patient
2. Aortocaval compression occurs at approximately 20 weeks of gestation when the parturient is positioned supine and the gravid uterus compresses both the aorta and inferior vena cava. This makes…
Craniofacial Surgery—Pediatric Considerations
FIGURE 18.1 Morphologic types of craniosynostosis. Diagrammatic views of different morphologic types of craniosynostosis are shown in the center of the figure. The premature closed suture is marked as a…
Anesthetic Effects on Cerebral Blood Flow and Metabolism
1 The decrease in metabolism seen with the volatile anesthetics is due to a reduction in organized neurotransmission, reaching a maximum reduction in CMRO2 of approximately 50% when an isoelectric…
Stroke and Brain Protection
23 Stroke and Brain Protection John Dunford I. Introduction II. Pathophysiology of cerebral ischemia A. Histopathologic events B. Biochemical events C. Necrotic cell death D. Apoptotic cell death E. Autophagy…
Anesthetic-induced Neurotoxicity
24 Anesthetic-induced Neurotoxicity Andreas W. Loepke and Mary Ellen McCann I. Introduction II. Effects of exposure to anesthetics, sedatives, and analgesics on the developing animal brain A. Deleterious effects of…
Epilepsy Surgery
19 Epilepsy Surgery Hubert A. Benzon, Craig D. McClain, and Heidi M. Koenig I. Background II. Physiologic considerations III. Imaging techniques IV. Surgical treatment V. Surgical resection of seizure foci…
