Routine Craniotomy for Supratentorial Masses
FIGURE 4.1 Schematic diagram of the intracranial pressure (ICP)–volume relationship (elastance). As intracranial volume increases (A to B) compensation occurs resulting in minimal increase in ICP, but as elastance decreases…
Traumatic Brain Injury
CLINICAL PEARL In-hospital treatment of TBI should focus on minimizing secondary insults to the injured brain due to hypotension, hypoxemia, hypercarbia, hypocarbia, hyperthermia, intracranial hypertension, seizures, hypoglycemia, and hyperglycemia. A….
Functional Neurosurgery
FIGURE 14.1 Deep brain nuclei: Targets for brain electrodes. 1. Parkinson’s disease. Parkinson’s disease is a neurodegenerative condition due to loss of dopaminergic cells in the substantia nigra. Dopamine inhibits…
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,…
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…
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…
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…