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Anesthesia for Functional Neurosurgery

  • Zulfiqar Ali
  • Hemanshu Prabhakar
Chapter

Abstract

Functional neurosurgery is efficacious for treating a variety of disorders as Parkinson’s disease, essential tremor, muscle dystonias, refractory epilepsy, psychiatric disorders, chronic pain, and persistent vegetative state. The rapid growth in imaging technology over the past few years has introduced the use of magnetic resonance thermography, laser, and focused ultrasound into clinical practice. General anesthesia is preferred for magnetic resonance imaging-guided DBS placement as the electrode localization is guided by the imaging rather than awake neurophysiologic testing. Functional ultrasound procedures for treatment of essential tremor or dystonia are minimally invasive procedures. Hence, general anesthesia is avoided in these procedures. Proximity to speech or motor area may make it necessary for the patient to be awake during the procedure. Hence, awake craniotomy under a scalp nerve block may be planned for such procedures. The anesthesiologist needs to be familiar with the technological advancements, pathophysiology of the underlying disease processes, and surgical procedures to optimize the anesthetic concerns, ensure patient safety, and improve surgical outcome in these procedures.

Keywords

Functional neurosurgery Focused ultrasound Deep brain stimulation Parkinson disease Epilepsy surgery 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Zulfiqar Ali
    • 1
  • Hemanshu Prabhakar
    • 2
  1. 1.Division of Neuroanesthesiology, Department of AnesthesiologySher-i-Kashmir Institute of Medical Sciences SouraSrinagarIndia
  2. 2.Department of Neuroanaesthesiology and Critical CareAll India Institute of Medical SciencesNew DelhiIndia

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