Essentials of Neurosurgical Anesthesia & Critical Care Strategies for Prevention, Early Detection, and Successful Management of Perioperative Complications

Encompasses clinical continuum from neurosurgical pre-op to critical care – plus anesthesia in neuroradiology
Adult and pediatric care
Structured algorithmic approach supports clinical decision-making
Succinct presentation of clinically relevant basic science
End-of-chapter summaries, with suggestions for further reading
Collaborative approach and multidisciplinary nature of perioperative medicine emphasized
Extensive tables and figures
Portable and formatted for quick retrieval of information
Ideal for use in the OR, the PACU, and the ICU
This handbook is aimed at first-line health care providers involved in the perioperative care of adult and pediatric neurosurgical patients. It is unique in its systematic focus on how to deal with common and important clinical challenges encountered in day-to-day practice in the OR, the PACU, and the ICU and is designed as a problem-solving tool for all members of the perioperative medicine team: trainees and faculty in anesthesiology, neurosurgery, and critical care; nurses; nurse anesthetists; and physician’s assistants.



• Encompasses clinical continuum from neurosurgical pre-op to critical care – plus anesthesia in neuroradiology

• Adult and pediatric care

• Structured algorithmic approach supports clinical decision-making

• Succinct presentation of clinically relevant basic science

• End-of-chapter summaries, with suggestions for further reading

• Collaborative approach and multidisciplinary nature of perioperative medicine emphasized

• Extensive summary tables

• Portable and formatted for quick retrieval of information

• Ideal for use in the OR, the PACU, and the ICU

TABLE OF CONTENTS
Preface

Part I. Basics of Neuroanesthesia Care
1. The Adult Central Nervous System: Anatomy and Physiology
Punita Sharma, MD, and Frederick Sieber, MD

2.Neuroendocrine Physiology: Fundamentals and Common Syndromes
Joshua H. Atkins, MD, PhD

3. Cerebral Edema: Pathophysiology and Principles of Management
Andrea Orfanakis, MD

4. Management of Fluids, Electrolytes and Blood Products in Neurosurgical
Patients
Renata Rusa, MD and Sadeq Quraishi, MD, MHA

5. Key Monitoring in Neuroanesthesia: Principles, Techniques and Indications
Martin Smith, MBBS, FRCA

Part II. Preoperative Concerns of the Neuroanesthesiologist

6. Cardiovascular Risk and Instability: Evaluation, Management and Triage
Philip E. Lund, MD and Jeffrey R. Kirsch, MD

7. Risk Assessment of Critical Carotid Stenosis Treatment: Suggestions for Perioperative Management
Elizabeth M Macri, MD.

8. Subarachnoid Hemorrhage: Risk Assessment and Perioperative Management
Chanhung Z. Lee, MD, PhD, Pekka Talke, MD, and Susan Ryan, MD, PhD

9. Traumatic Brain Injury: Risk Assessment and Perioperative Management
Lingzhong Meng, MD

10. Rare Neurologic Disorders and Neuromuscular Diseases: Risk Assessment and Perioperative Management
Nicholas Hirsch, MBBS, FRCA FRCP

11. Perioperative Pharmacotherapy in Neurosurgery: Risk Assessment and Planning
Alejandro E. Delfino, MD and Hernán R. Muñoz, MD, MSc

12. Specific Considerations Regarding Consent and Communication with Patients and Family Prior to Neurosurgery
Kenneth Abbey, MD, JD and Chloe Allen-Maycock, MD

Part III. Fundamentals of Adult Neurosurgery and Neuroanesthesia

13. Preparing for Anesthesia in Neurosurgical Patients
Andrea M. Dower BSc MD FRCPC and Pirjo Manninen MD FRCPC

14. Basics of Neurosurgical Techniques and Procedures Kenneth C. Liu, MD; Murat Oztaskin; and Kim J. Burchiel, MD

15. Positioning the Patient for Neurosurgical Operations
Alexander Zlotnik, MD; Monica S. Vavilala, MD; and Irene Rozet, MD

16. The Intra-Operative Team: Getting the Most Out of Collaborative Care in the Operating Room
Debra Reeves, RN

Part IV. Critical Situations During Anesthesia for Brain Surgery in Adults

17. The “Tight Brain”: Cerebral Herniation Syndrome
Leslie C. Jameson, MD, Paul D. Mongan, MD, Daniel J. Janik, MD, and Tod B. Sloan, MD, MBA, PhD

18. Cerebral Ischemia: Options for Perioperative Neuroprotection
Martin Soehle, MD

19. Massive Hemorrhage during Craniotomy: Emergency Management
Lawrence Lai, MD and Audrée A. Bendo, MD

20. Challenges During Anesthesia for Awake Craniotomy
Judith Dinsmore, MBBS, FRCA

21. Perioperative Challenges During Stereotactic Neurosurgery and Deep Brain Stimulator Placement
Marc A. Bloom, MD, PhD

22. Perioperative Challenges During Posterior Fossa Surgery
Martin Schott, MD; Dieter Suhr, MD; and Jan-Peter Jantzen, MD, PhD

23. Perioperative Challenges During Release of Subdural and Epidural Hemorrhage
Walter van den Bergh, MD, PhD and Olaf Cremer, MD

24. Perioperative Challenges During Cerebrovascular Surgery
Jeremy D. Fields, MD; Kenneth C. Liu, MD; and Ansgar Brambrink, MD, PhD

25. Perioperative Challenges During Pituitary Surgery
Shuji Dohi, MD, PhD

26. Perioperative Challenges During Craniotomy for Space-Occupying Brain Lesions
Chanannait Paisansathan MD and Verna L Baughman MD

Part V. Critical Situations During Anesthesia for Spinal Surgery in Adults

27. Perioperative Challenges in Patients with Unstable Spine
Carl Helge Nielsen, M.D.

28. Airway crisis associated with cervical spine surgery
Edward Crosby MD, FRCPC

29. Spinal Cord Injury During Spinal Surgery
Masahiko Kawaguchi

30. Blood Loss During Spinal Surgery
Matthew TV Chan, MBBS, FANZCA, FHKCA, FHKAM and Patricia KY Kan, MBBS, FANZCA, FHKCA, FHKAM

31. Coagulopathy in spinal surgery
Andrew H. Milby, BS, Casey H. Halpern MD, and James M. Schuster MD, PhD

32. Postoperative Visual Loss Following Spinal Surgery
Lorri Lee, MD

Part VI. Critical Situations During Anesthesia for Other Procedures in Adult Surgery

33. Perioperative Challenges During Diagnostic and Perioperative Magnetic Resonance Imaging (MRI)
Peter A. Farling. MB, BCh, BAO, FFARCSI, FRCA and Richard C. Corry, MB, ChB, FRCA

34. Perioperative Challenges During Electroconvulsive Therapy (ECT)
Carrie C. Bowman MS, CRNA and James G. Hilliard MS, CRNA

35. Perioperative Challenges During Carotid Artery Revascularization
Ursula Schulz, MD and Peter Rothwell, MD

Part VII. Specific Perioperative Concerns in Adult Neuroanesthesia
36. Venous Air Embolism During Surgery
Liping Zhang, MD, Min Li, MD, and Chris C. Lee, MD, PhD

37. Arterial Hypotension and Hypertension During Neurosurgical Procedures
Kirstin M. Erickson M.D. and Daniel J. Cole M.D.

38. Hyperthermia and Hypothermia During Neurosurgical Procedures
Akiva Leibowitz, MD, Evgeni Brotfain, MD, Yoram Shapira MD, PhD

39. Challenges Associated with Perioperative Monitoring During Neurosurgery
Osama Ahmed, MD, and Claudia Robertson, MD

40. Unintended Wake-up During Surgery
Jeffrey Yoder, MD, and Chris C. Lee, MD, PhD

41. Cardiac arrest/Code
Michael Bernhard, Jürgen Knapp, and Bernd W. Böttiger

42. Arousal From Anesthesia After Neurosurgical Operations
W. Scott Jellish, M.D., Ph.D.

43. Communication Challenges During The Perioperative Period
David Murray, MD

Part VIII. Fundamentals of Pediatric Neurosurgery and Neuroanesthesia
44. Anatomy and physiology of the central nervous system in children
Stuart Friess, MD, Todd J. Kilbaugh, MD, and Mark Helfaer, MD

45. Pediatric Anesthetic Care Requirements
Gregory J. Latham, MD and Donald Shaffner, MD

46. The Pediatric Airway in Neurosurgery
Debra E. Morrison, MD, and Zeev N. Kain, MD

47. Specific Aspects of Positioning and Fluids, Glucose, and Temperature Management in Children Undergoing Neurosurgical Procedures
Gerhard K. Wolf, MD, John H. Arnold, MD, and Sulpicio G. Soriano, MD, FAAP

Part IX. Critical Situations During Anesthesia for Pediatric Surgery

48. Challenges During Surgery for Hydrocephalus
Inger Aliason, MD, and Jeffrey Koh, MD

49. Challenges During Surgery for Traumatic Brain Injury
Chinwe Ajuba-Iwuji, MD and Dolores B. Njoku, MD

50. Challenges During Surgery for Meningomyelocele and Encephalomyelocele
Allison Kinder Ross, MD

51. Challenges During Cranial Decompression
Todd J. Kilbaugh, MD, Stuart Friess, MD, and Mark Helfaer, MD

52. Challenges During Surgery for Craniosynostosis and Craniofacial Surgery
Heike Gries, MD, PhD and Jeffrey Koh, MD

53. Challenges During Tumor Surgery in Children and Infants
Christopher Karsanac, MD and Jayant Deshpande, MD, MPH

54. Challenges During Surgery for Vascular Anomalies in Pediatrics
Edward R. Smith, MD, Craig D. McClain, MD, MPH, and Sulpicio G. Soriano, MD, FAAP

55. Challenges During Epilepsy Surgery in Pediatric Patients
Abraham Rosenbaum, MD and Zeev N. Kain, MD

56. Challenges During Pediatric Endoscopic Neurosurgery
Nina Deutsch, MD

Part X. Postoperative Concerns in Neuroanesthesia
57. Emergence From Anesthesia Following Pediatric Neurosurgery
Kirk Lalwani, M.D., F.R.C.A., M.C.R.

58. Postanesthesia Care Unit Risks Following Pediatric Neurosurgery
Sally E Rampersad, MB, FRCA and Lynn D. Martin, MD, FAAP, FCCM

59. Intensive Care Risks of Pediatric Neurosurgery
Craig D. McClain, MD, MPH and Michael McManus, MD, MPH

Part XI. Fundamentals of Interventional Neuroradiology
60. Radiation Safety in Interventional Neuroradiology
Justin P. Dodge, M.D.; Neil E. Roundy, M.D. and Kenneth C. Liu, M.D.

61. Understanding Basic Techniques and Procedures in Interventional Neuroradiology
Kenneth C. Liu, MD; Lori E. Guidone, PA-C; and Stanley L. Barnwell, MD, PhD

62. Basics of Image Interpretation in Interventional Neuroradiology
Wibke Mueller-Forell, MD, PhD

Part XII. Specific Concerns Regarding Anesthesia for Interventional Neuroradiology
63. Procedural Challenges in Interventional Neuroradiology
William L. Young, MD

64. Anesthesiological Challenges During Neuroradiological Interventions
Michael Aziz, MD and Ansgar Brambrink, MD, PhD

65. Specific Challenges During Neuroradiological Interventions in Pediatric Patients
Tariq Parray, MD and Timothy W. Martin, MD

Part XIII. Challenges During Postoperaitve Anesthesia Care After Neurosurgery
66. Surgical Emergencies After Neurosurgery
R. Alexander Schlichter, MD

67. Airway Emergencies After Neurosurgery
Yulia Ivashkov, MD and Karen B. Domino, MD, MPH

68. Neurologic Emergencies After Neurosurgery
Doortje Engel, MD and Andrew Maas, MD

69. Hemodynamic Complications After Neurosurgery
Jeffrey Yoder, MD and Rene Tempelhoff MD

70. Endocrinologic Emergencies After Neurosurgery
Ola Harrskog, MD, DEAA and Robert E. Shangraw, MD, PhD

71. Postoperative Paralysis, Skin Lesions, and Corneal Abrasions After Neurosurgery
Martin H. Dauber, MD and Steven Roth, MD

72. Postoperative pain management in patients after neurosurgical operations
Mary Newton MBBS, FRCA and Tacson Fernandez MBBS, FCARCSI, FIPP

73. Management of Postoperative Nausea and Vomiting After Neurosurgery
Concezione Tommasino, MD

74. The Transport of Neurosurgical Patients
Laurel E. Moore, M.D.

Part XIV. Challenges in Neurocritical Care of Neurosurgical Patients
75. Altered Mental Status in Neurosurgical Critical Care
Christoph S. Burkhart MD, Stephan P. Strebel MD, Luzius A. Steiner, MD PhD

76. Cerebrovascular Vasospasm, Normal Pressure Breakthrough Edema, Posterior Reversible Encephalopathy Syndrome (PRES) in Neurosurgical Critical Care
Syed Arshad, MD; José I. Suarez, MD

77. Sedation, Analgesia, and Neuromuscular Blockade in Neurosurgical Critical Care
Miko Enomoto, MD and Ansgar Brambrink, MD, PhD

78. Airway and Pulmonary Management in Neurosurgical Critical Care
Edward M Manno M.D.

79. Myocardial and Vascular Management in Neurosurgical Critical Care
E. Paige Gerbic MD and Valerie Sera MD

80. Nutrition and Glucose Management in Neurosurgical Critical Care
Michael Souter M.B., Ch.B., F.R.C.A. , and Arthur M. Lam, MD, FRCPC

81. Fluid and Electrolyte Management in Neurosurgical Critical Care
Guillermo Bugedo, MD, and Luis Castillo, MD

82. Temperature Management in Neurosurgical Critical Care
Martin H. Dauber, MD

83. Coagulation Management in Neurosurgical Critical Care
Sarice Bassin, MD and Thomas Bleck, MD

84. Gastrointestinal Hemorrhage in Neurosurgical Critical Care
Meghan Bost, M.D., and Kamila Vagnerova, M.D.

85. Intracranial Monitors in Neurosurgical Critical Care
Patricia H. Petrozza, MD

86. Central Nervous System Infection in Neurosurgical Critical Care
Mary K. Sturaitis, MD

87. Antiepileptic Drug Therapy in Neurosurgical Critical Care
Panayiotis N. Varelas, MD, PhD and Denise H. Rhoney, Pharm.D

88. Withdrawal of mechanical ventilation in neurosurgical critical care
Paul Bascom, MD

89. Brain Death in Neurosurgical Critical Care
Amit Parkash, MD, FRCA and Basil Matta FRCA

90. Organ Donation in Neurosurgical Critical Care
Pamela A. Lipsett, MD, FACS, FCCM

91. Interaction with Family and Friends in Neurosurgical Critical Care
Amy E Guthrie MSN; Robert Hugo Richardson, MD; and Mary Denise Smith, MSN, CNS, ACHPN

Index