By Ansgar M. Brambrink, Jeffrey R. Kirsch

This instruction manual is aimed toward first-line overall healthiness care prone desirous about the perioperative care of grownup and pediatric neurosurgical sufferers. it's exact in its systematic concentrate on the way to care for universal and demanding medical demanding situations encountered in daily perform within the OR, the PACU, and the ICU and is designed as a problem-solving software for all contributors of the perioperative drugs group: trainees and school in anesthesiology, neurosurgery, and important care; nurses; nurse anesthetists; and physician’s assistants.


• Encompasses medical continuum from neurosurgical pre-op to serious care – plus anesthesia in neuroradiology

• grownup and pediatric care

• dependent algorithmic method helps medical decision-making

• Succinct presentation of clinically proper easy science

• End-of-chapter summaries, with feedback for additional reading

• Collaborative procedure and multidisciplinary nature of perioperative drugs emphasized

• broad precis tables

• transportable and formatted for speedy retrieval of information

• perfect to be used within the OR, the PACU, and the ICU

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

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Depressed level of consciousness with dilated pupils is the first clinical sign of a herniation syndrome and is usually accompanied by a Cushing response (elevation in the systolic blood pressure with accompanying bradycardia). 20 P. Sharma and F. Sieber Key Points • In the corticospinal tract, lesions above the medullary decussation cause contralateral paralysis and those below medullary decussation cause ipsilateral paralysis. • Brain anatomy is important in identifying the different non-silent areas of the brain with respect to the surgical procedure being performed and helps to prevent devastating deficits.

The blood–brain barrier (BBB) isolates the brain from the plasma and is formed by the interaction of capillary endothelial cells with astrocytes in the brain. Water, gases, glucose, and lipophilic substances are freely permeable through the BBB. Proteins and polar substances are poorly permeable through the BBB. The brain is protected from the circulating toxins by the BBB. The brain tissue has a high energy requirement and is responsible for about 20% of total body oxygen consumption. 5 ml/100 g/min in adults.

The ligaments provide flexibility without allowing excessive movement which could damage the cord. The human spine is also affected by aging. The intervertebral disks become drier, more fibrous and less resilient. The spinal cord is a long cylindrical structure covered by membranes which lies in the vertebral canal. The spinal cord is the continuation of the medulla. It extends 8 P. Sharma and F. Sieber Superior sagittal sinus Inferior sagittal sinus Emissary vein Great cerebral vein Rectus sinus Frontal vein Ophthalmic veins Transverse sinus Cavernous sinus Superior petrosal sinus Inferior petrosal sinus Pterygoid plexus Occipital vein Anterior facial vein Internal jugular vein Fig.

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