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Complications in Neuroanesthesia focuses on complications that may arise related to neuroanesthesia practice and discusses its various causes. Each complication is written as a separate chapter, and the pathophysiology and mechanisms of each complication, as well as measures for diagnosis, treatment and prevention are discussed. Towards the end of the book, several case scenarios are provided to the readers that challenge readers to diagnose the possible complication for each case. Chapters include brain and spinal cord problems, cardiovascular and hematological problems, and nerve and muscle problems. Written in a standard format, Complications in Neuroanesthesia provides quick and easy access to understanding problems in neuroanesthesia. It provides insight into all possible complications occurring during perioperative management of neurosurgical and neurologic patients. It is useful for trainees, clinicians, and researchers in the fields of neurosurgery, neurocritical care, and neurology by providing an understanding of preventable mishaps that may occur in neurosurgical or neurologic patients. - Quick and easy reference for understanding problems in neuroanesthesia - Provides comprehensive insights into all possible complications occurring during perioperative management of neurosurgical and neurologic patients - Includes useful section with clinical case studies of complications in neuroanesthesia
This open access book presents the diagnosis, investigation and treatment of neurovascular diseases, and offers expert opinions and advice on avoiding complications in neurovascular surgery. It also covers complication management and post-operative follow-up care. The book is divided in to three parts; the first part discusses common approaches in neurovascular surgery, describing the steps, indications for and limitations of the approach, as well as the associated complications and how to avoid them. The second part addresses surgical treatment based on pathology, taking the different locations of lesions into consideration. The third part focuses on the technological developments that support neurovascular surgery, which may not be available everywhere, but have been included to help vascular surgeon understand the principles. This book is a guide for young neurosurgeons, neurosurgery residents and neurosurgery fellows, as well as for medical students and nurses who are interested in neurosurgery or are associated with this field in any way. It is also a useful teaching aid for senior neurosurgeons.
This e-book will review special features of the cerebral circulation and how they contribute to the physiology of the brain. It describes structural and functional properties of the cerebral circulation that are unique to the brain, an organ with high metabolic demands and the need for tight water and ion homeostasis. Autoregulation is pronounced in the brain, with myogenic, metabolic and neurogenic mechanisms contributing to maintain relatively constant blood flow during both increases and decreases in pressure. In addition, unlike peripheral organs where the majority of vascular resistance resides in small arteries and arterioles, large extracranial and intracranial arteries contribute significantly to vascular resistance in the brain. The prominent role of large arteries in cerebrovascular resistance helps maintain blood flow and protect downstream vessels during changes in perfusion pressure. The cerebral endothelium is also unique in that its barrier properties are in some way more like epithelium than endothelium in the periphery. The cerebral endothelium, known as the blood-brain barrier, has specialized tight junctions that do not allow ions to pass freely and has very low hydraulic conductivity and transcellular transport. This special configuration modifies Starling's forces in the brain microcirculation such that ions retained in the vascular lumen oppose water movement due to hydrostatic pressure. Tight water regulation is necessary in the brain because it has limited capacity for expansion within the skull. Increased intracranial pressure due to vasogenic edema can cause severe neurologic complications and death.
The brain is the most complex organ in our body. Indeed, it is perhaps the most complex structure we have ever encountered in nature. Both structurally and functionally, there are many peculiarities that differentiate the brain from all other organs. The brain is our connection to the world around us and by governing nervous system and higher function, any disturbance induces severe neurological and psychiatric disorders that can have a devastating effect on quality of life. Our understanding of the physiology and biochemistry of the brain has improved dramatically in the last two decades. In particular, the critical role of cations, including magnesium, has become evident, even if incompletely understood at a mechanistic level. The exact role and regulation of magnesium, in particular, remains elusive, largely because intracellular levels are so difficult to routinely quantify. Nonetheless, the importance of magnesium to normal central nervous system activity is self-evident given the complicated homeostatic mechanisms that maintain the concentration of this cation within strict limits essential for normal physiology and metabolism. There is also considerable accumulating evidence to suggest alterations to some brain functions in both normal and pathological conditions may be linked to alterations in local magnesium concentration. This book, containing chapters written by some of the foremost experts in the field of magnesium research, brings together the latest in experimental and clinical magnesium research as it relates to the central nervous system. It offers a complete and updated view of magnesiums involvement in central nervous system function and in so doing, brings together two main pillars of contemporary neuroscience research, namely providing an explanation for the molecular mechanisms involved in brain function, and emphasizing the connections between the molecular changes and behavior. It is the untiring efforts of those magnesium researchers who have dedicated their lives to unraveling the mysteries of magnesiums role in biological systems that has inspired the collation of this volume of work.
This book aims to cover the majority of neurovascular diseases and management. The first section reviews neurovascular anatomy, the basics of angiography, and the basics of craniotomies for neurovascular diseases. Next, an entire section is devoted to intracranial aneurysms, covering the natural history, subarachnoid hemorrhage, endovascular management, microsurgical management, and vasospasm. Following this, a number of chapters are devoted to stroke including natural history, mechanical thrombectomy, intracranial stenosis, Moyamoya disease, bypass surgery, vertebrobasilar insufficiency, intracerebral hemorrhage, sinus thrombosis, and the surgical and endovascular management of extracranial carotid disease. Next, the text covers vascular malformations including arteriovenous malformation, arteriovenous fistulas, carotid cavernous fistulas, vein of Galen malformations, spinal malformations, and cavernous malformations. Finally, the book discusses a few miscellaneous topics including more recent advances in neurovascular care such as venous sinus stenting for idiopathic intracranial hypertension and middle meningeal artery embolization for subdural hematoma. Written by experts in the field, Introduction to Vascular Neurosurgery provides a comprehensive summary of neurovascular disease and management. The book can be used as a daily reference and serves as a trusted resource for medical students, residents, fellows, and young attendings.
This book focuses on subarachnoid hemorrhage (SAH), describing in detail the neurophysiology, anatomy, epidemiology, grading, anesthesia management, coiling and interventional treatment of this dangerous disease. Written by leading international experts, it highlights the state-of-the-art techniques for the diagnosis and treatment (non-surgical and surgical) of SAH and the clinical variations. It also examines the reliability of the new techniques versus the standard clinical methods to predict problems related to SAH and its recent diagnosis and management. The book starts with a brief discussion of the epidemiology of SAH, cerebral circulation, anatomy of brain blood vessels and neurophysiology related to this fatal disease. Then, in the following chapters it covers grading of subarachnoid hemorrhage, anesthesia management of SAH, treatment, subarachnoid hemorrhage coiling and radiological intervention. Lastly, it explores surgical treatment of intracranial aneurysms in more detail, and addresses complications, critical care management and headache in SAH, traumatic SAH and prognosis. Featuring numerous images, tables, schema, illustrations and videos, the book is intended for junior and senior anesthesiologists, neuroscientists, intervention radiologists, intensivists and neurosurgeons.
New and groundbreaking therapeutic options for the critical care of patients with cerebrovascular disease have improved patient management, minimized morbidity, reduced in-patient care, improved quality of life, and had a positive economic impact on health service provision. This volume integrates these approaches and suggests the best therapy option for all cerebrovascular conditions. The early chapters of the book focus on monitoring techniques and interventions. Subsequent sections address the critical care of a wide range of cerebrovascular diseases: ischemic stroke, intracranial hemorrhage, subarachnoid hemorrhage, arteriovenous malformations, cerebral venous thrombosis and traumatic injury. The editors and authors are internationally recognized experts in their field, and the text is supplemented by tables and illustrations to demonstrate important clinical findings. This book will meet the needs of stroke physicians, neurologists, neurosurgeons, neurointensivists and interventional neuroradiologists seeking to maximize positive outcomes for their patients.
Learn from key leaders in the field of neurosurgery with the practical guidance presented in this first-of-its-kind resource. Complications in Neurosurgery uses a case-based format to explore complications across the full range of commonly performed neurosurgical procedures. As you review dozens of up-to-date, real-life cases, you'll become better equipped to identify pitfalls ahead of time and have the knowledge to handle difficult situations that arise during surgery. - Presents commonly encountered cases provided by experienced neurosurgeons in all areas of this challenging specialty. - Includes high-quality photographs, images, and dynamic video to ensure complete visual understanding of the procedures. - Uses a consistent, easy-to-read format throughout, covering a wide range of surgeries including general neurosurgery and cranial complications, as well as spinal and peripheral complications. - Numerous videos depict possible complications for each type of surgery; for example, Complications of Cerebral Bypass Surgery includes videos showing how to obtain venous hemostasis without risking injury to the STA, how to manage atheroma within the donor vessel, and how to manage intraoperative occlusion of the bypass.
Every few years a dissertation comes to the area of clinical application of medical technology which carries us forward as on a magic carpet into new regions of understanding and patient care. This book is such a magic carpet. It brings together, in a clear and incisive fashion, important hemodynamic principles with a simple noninvasive method of application to a part of the cerebral vasculature which has been relatively inaccessible. To the lucky and perceptive person who reads this book, a feeling of excitement and hope for progress is engendered. The diligent application of the potentials of transcranial Doppler ultrasound brings new power to our efforts in understanding the cerebral circulation and the causes, treatment and prevention of cerebrovascular disorders. Merrill P. Spencer, M. D. Director Institute of Applied Physiology and Medicine Seattle, Wash. , July 1986 Acknowledgements I am greatly indebted to Prof. He1ge Nornes, Oslo, who introduced me to the fascinating study of cerebral hemodynamics in the early 1970's and since then continually encouraged my interest in this field. It was through his pioneering work on the cerebral circulation-using peroperative electromagnetic flowmetry and Doppler techniques-that the basis was laid for the noninvasive trans cranial approach to the circle of Willis described in this book. I also gratefully acknowledge the stimulating case discussions with Prof. Peter Huber, Berne, at the very early introduction of trans cranial Doppler, the inspiring exchange of ideas with Dr. Merrill P.
Neurointervention is a fast-growing subspecialty, and recent trials have demonstrated its role in ischaemic and haemorrhagic stroke. This has generated tremendous interest among interventional neuroradiology, neurology and neurosurgery communities. Nevertheless, formal teaching programmes that provide the required experience are limited, and many early career practitioners are not exposed to the crucial technical details essential to safely performing the procedure before they start practising independently. The book presents 100 characteristic case studies to illustrate the salient technical and clinical issues in decision-making and problem solving during the procedure. This book conveys the “real-world” issues and solutions that are not addressed in detail in most books. As such it is a practical teaching book with useful “tips and tricks” on how to handle specific challenging situations, and is particularly useful for fellows in neurointervention training programmes..