By Elizabeth A. M. Frost

ISBN-10: 0409901717

ISBN-13: 9780409901719

Written by means of a staff of anaestheiologists and neurosurgeons, this article presents an in-depth and finished overview of the medical method of anaesthesia from the elemental technological know-how and anatomy and body structure of the intracranial contents to mind dying, electrophysiology, discomfort administration and neuroradiology. This variation has been elevated to incorporate advances in neuroanaesthesia and large references

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Sample text

Low closing pressures will avoid damage to the endothelium of intracranial vessels (82). Agents to enhance the brain's toler­ ance to ischemia have been proposed. The physio­ logical alterations that may result from these and other maneuvers are presented. vessel, blood does not accelerate uniformly; in­ stead, the cellular components tend to pool in the middle of the flowing stream, where the acceler­ ation is greatest (83). This characteristic varies with the size of the lumen, so that statements made about larger arteries are not applicable to smaller vessels (84).

Pa­ tients with central nervous system disease processes require careful consideration, for they may react in an unpredictable fashion to anes­ thetic agents due to a malfunction of these sys­ tems. All anesthetic agents and techniques alter intracranial dynamics. Furthermore, regardless of the primary insult to the CNS (occlusive vascular disease, tumor, or trauma), the interaction be­ tween forces may ultimately create conditions not favorable to cerebral perfusion, so that ischemic injury is often the final common pathway of insult to the CNS (111-113).

It passes through the foramen of Monro into the third ven­ tricle, through the third and into the aqueduct of Sylvius, and from there into the fourth ventricle. At that point, CSF passes through a median aper­ ture, the foramen of Magendie, as well as bilateral apertures, the foramina of Luschka, into the cis­ terna magna. It then appears to pass caudally along the posterior spinal subarachnoid space and then cranially along the anterior space. Current eddies are also noted in both directions in these spaces (53,54).

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Clinical Anesthesia in Neurosurgery by Elizabeth A. M. Frost


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