TY - CHAP M1 - Book, Section TI - Anesthesia for Neurosurgery A1 - Butterworth IV, John F. A1 - Mackey, David C. A1 - Wasnick, John D. Y1 - 2022 N1 - T2 - Morgan & Mikhail’s Clinical Anesthesiology, 7e AB - KEY CONCEPTS Regardless of the cause, intracranial masses present symptoms and signs according to growth rate, location, and intracranial pressure. Slowly growing masses are frequently asymptomatic for long periods (despite relatively large size), whereas rapidly growing ones may present when the mass remains relatively small. Computed tomography and magnetic resonance imaging scans should be reviewed for evidence of brain edema, midline shift greater than 0.5 cm, or ventricular displacement or compression. Operations in the posterior fossa can injure vital circulatory and respiratory brainstem centers, as well as cranial nerves or their nuclei. Venous air embolism can occur when the pressure within an open vein is subatmospheric. These conditions may exist in any position and during any procedure whenever the wound is above the level of the heart. Optimal recovery of air following venous air embolism is provided by a multiorificed catheter positioned in advance at the junction between the right atrium and the superior vena cava. Confirmation of correct catheter positioning can be accomplished by intravascular electrocardiography, radiography, or transesophageal echocardiography. In a patient with head trauma, correction of hypotension and control of any bleeding take precedence over radiographic studies and definitive neurosurgical treatment because systolic arterial blood pressures of less than 80 mm Hg predict a poor outcome. Sudden, massive blood loss from injury to adjacent great vessels can occur intraoperatively with thoracic or lumbar spine procedures. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1190607150 ER -