TY - CHAP M1 - Book, Section TI - Neuroanesthesia A1 - Avitsian, Rafi A1 - Farag, Ehab A2 - Longnecker, David E. A2 - Mackey, Sean C. A2 - Newman, Mark F. A2 - Sandberg, Warren S. A2 - Zapol, Warren M. PY - 2017 T2 - Anesthesiology, 3e AB - KEY POINTSAn important anatomic and physiologic characteristic of the cranium is its closed system. To provide adequate perfusion, the total volume of the brain parenchyma, cerebrospinal fluid, and blood should not increase.Cerebral blood flow (CBF) and cerebral blood volume (CBV) are separate but related entities. Maintaining adequate CBF is important for neurons, but high CBF can increase the intracranial pressure (ICP).Hemodynamic effects of anesthesia and changes in the Paco2 and cerebral metabolic rate can alter the CBV, ICP, and CBF.The management of most neurosurgical procedures requires invasive and specialized monitoring methods that can give information about blood supply, oxygen utilization, and electrical activity of the brain and spinal cord.Maintaining an appropriate cerebral perfusion pressure and optimal surgical conditions is important during supratentorial and infratentorial craniotomies and other neurosurgical procedures.Both secreting and nonsecreting pituitary tumors can cause significant changes in the function of many organ systems and affect the perioperative care of patients undergoing surgical procedures.Intracranial aneurysms and arteriovenous malformations are two important intracranial vascular abnormalities and require specific perioperative care.Interventional neuroradiology is a new specialty for the nonsurgical management of cerebral aneurysms and arteriovenous malformations. Understanding interventional neuroradiological techniques and ensuring hemodynamic stability are important during anesthetic management.The shunt and neuroendoscopy for obstructive hydrocephalus may cause hemodynamic changes such as severe bradycardia and can be associated with surgical complications such as hemorrhage and intracranial hypertension.The prone position during spine surgery can be associated with a decrease in cardiac index. Neck movement must be minimized during intubation and positioning of patients with cervical spine injuries, and hypotension should be avoided to ensure adequate spinal cord perfusion. Risk factors for ischemic optic neuropathy and postoperative visual loss after spine surgery include obesity, longer anesthetic duration, and large-volume blood loss. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1144120872 ER -