Skip to main content
SpringerLink
Log in

Anesthesia for Cerebrovascular Surgery

  • Chapter
Neuroanesthesia

Part of the book series: Developments in Critical Care Medicine and Anesthesiology ((DCCA,volume 32))

  • 86 Accesses

Abstract

The management of patients with intracranial vascular malformations has evolved considerably in the past 10–15 years. Anesthetic management has also undergone significant evolution. This review will address some specific areas of this evolution and focus on the two most common lesions treated surgically, namely, cerebral aneurysms and arteriovenous malformations (AVMs).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Andreoli A, diPasquale G, Pinelli G, et al: Subarachnoid hemorrhage: Frequency and severity of cardiac arrhythmias. A survey of 70 cases studied in the acute phase. Stroke 18:558–564, 1987

    Article  CAS  PubMed  Google Scholar 

  2. Young WL, Kader A, Pile-Spellman J, et al: Arteriovenous malformation draining vein physiology and determinants of transnidal pressure gradients. Neurosurgery 35:389–396, 1994

    Article  CAS  PubMed  Google Scholar 

  3. Rosner MJ: Cerebral perfusion pressure: Link between intracranial pressure and systemic circulation (Chapter 27), Cerebral Blood Flow: Physiologic and Clinical Aspects. Edited by Wood JH. New York, McGraw-Hill Book Company, 1987, pp 425–448

    Google Scholar 

  4. Paulson OB, Strandgaard S, Edvinsson L: Cerebral autoregulation. Cerebrovasc Brain Metab Rev 2:161–192, 1990

    CAS  PubMed  Google Scholar 

  5. Drummond JC, Shapiro HM: Cerebral physiology (Chapter 19), Anesthesia. Vol 1, 3rd ed. Edited by Miller RD. New York, Churchill Livingstone, 1990, pp 621–649

    Google Scholar 

  6. Zornow MH, Todd MM, Moore SS: The acute cerebral effects of changes in plasma osmolality and oncotic pressure. Anesthesiology 67:936–941, 1987

    Article  CAS  PubMed  Google Scholar 

  7. Warner DS, Boehland LA: The effects of iso-osmolal hemodilution on post-ischemic brain water content in the rat. Anesthesiology 68:8691, 1988

    Google Scholar 

  8. Tremble ER, JP, Misers JS, et al: Coagulopathy with the use of hetastarch in the treatment of vasospasm. J Neurosurg 82:44–47, 1995

    Article  Google Scholar 

  9. Lanier WL: Glucose management during cardiopulmonary bypass: Cardiovascular and neurologic implications (editorial). Anesth Analg 72:423–427, 1991

    Article  CAS  PubMed  Google Scholar 

  10. Busto R, Dietrich WD, Globus MY-T, et al: Small differences in intraischemic brain temperature critically determine the extent of ischemic neuronal injury. J Cereb Blood Flow Metab 7:729–738, 1987

    Article  CAS  PubMed  Google Scholar 

  11. Busto R, Dietrich WD, Globus MY-T, Ginsberg MD: The importance of brain temperature in cerebral ischemic injury. Stroke 20:1113–1114, 1989

    Article  CAS  PubMed  Google Scholar 

  12. Sano T, Drummond JC, Patel PM, et al: A comparison of the cerebral protective effects of isoflurane and mild hypothermia in a model of incomplete forebrain ischemia in the rat. Anesthesiology 76:221–228, 1992

    Article  CAS  PubMed  Google Scholar 

  13. Baker CZ, Young WL, Stone JG, et al: Deliberate mild intraoperative hypothermia for craniotomy. Anesthesiology 81:361–367, 1994

    Article  CAS  PubMed  Google Scholar 

  14. Frank SM, Beattie C, Christopherson R, et al: Unintentional hypothermia is associated with postoperative myocardial ischemia. Anesthesiology 78:468–476, 1993

    Article  CAS  PubMed  Google Scholar 

  15. Marion DW, Obrist WD, Carlier PM, et al: The use of moderate therapeutic hypothermia for patients with severe head injuries: A preliminary report. J Neurosurg 79:354–362, 1993

    Article  CAS  PubMed  Google Scholar 

  16. Chen H, Chopp M: Effect of mild hyperthermia on the ischemic infarct volume after middle cerebral artery occlusion in the rat. Neurology 41:1133–1135, 1991

    Article  CAS  PubMed  Google Scholar 

  17. Mayer SA, LiMandri G, Sherman D, et al: Electrocardiographic markers of abnormal left ventricular wall motion in acute subarachnoid hemorrhage. J Neurosurg 83:889–896, 1995

    Article  CAS  PubMed  Google Scholar 

  18. Davies KR, Gelb AW, Manninen PH, et al: Cardiac function in aneurysmal subarachnoid haemorrhage: A study of electrocardiographic and echocardiographic abnormalities. Br J Anaesth 67:58–63, 1991

    Article  CAS  PubMed  Google Scholar 

  19. Warner DS, Sokoll MD, Maktabi M, et al: Nicardipine HCI: Clinical experience in patients undergoing anaesthesia for intracranial aneurysm clipping. Can J Anaesth 36:219–223, 1989

    Article  CAS  PubMed  Google Scholar 

  20. Ornstein E, Matteo RS, Schwartz AE, et al: The effect of phenytoin on the magnitude and duration of neuromuscular block following atracurium or vecuronium. Anesthesiology 67:191–196, 1987

    Article  CAS  PubMed  Google Scholar 

  21. Abe K, Iwanaga H, Yoshiya I: The effect of nicardipine on carotid blood flow velocity, local cerebral blood flow, and carbon dioxide reactivity during cerebral aneurysm surgery. Anesth Analg 76:1227–1233, 1993

    CAS  PubMed  Google Scholar 

  22. Ravussin P, Tribolet ND: Total intravenous anesthesia with propofol for burst suppression in cerebral aneurysm surgery: Preliminary report of 42 patients. Neurosurgery 32:236–240, 1993

    Article  CAS  PubMed  Google Scholar 

  23. Tsementzis SA, Hitchcock ER: Outcome from “rescue clipping” of ruptured intracranial aneurysms during induction anaesthesia and endotracheal intubation. J Neurol Neurosurg Psych 48:160–163, 1985

    Article  CAS  Google Scholar 

  24. Schramm J, Cedzich C: Outcome and management of intraoperative aneurysm rupture. Surg Neurol 40:26–30, 1993

    Article  CAS  PubMed  Google Scholar 

  25. Abe K, Iwanaga H, Inada E: Effect of nicardipine and diltiazem on internal carotid artery blood flow velocity and local cerebral blood flow during cerebral aneurysm surgery for subarachnoid hemorrhage. J Clin Anesth 6:99–105, 1994

    Article  CAS  PubMed  Google Scholar 

  26. Ornstein E, Young WL, Fleischer LH, Ostapkovich N: Desflurane and isoflurane have similar effects on cerebral blood flow in patients with intracranial mass lesions. Anesthesiology 79:498–502, 1993

    Article  CAS  PubMed  Google Scholar 

  27. Fleischer LH, Young WL, Ornstein E, Smiley RS: Systemic hemodynamic changes of desflurane vs isoflurane during anesthetic induction (abstract). Anesthesiology 77:A334, 1992

    Article  Google Scholar 

  28. Baker KZ, Ostapkovich N, Jackson T, et al: Cerebral blood flow reactivity is intact during remifentanil/N2O anesthesia (abstract). Anesth Analg 80:S27, 1995

    Google Scholar 

  29. Manninen PH, Cuillerier DJ, Nantau WE, Gelb AW: Monitoring of brainstem function during vertebral basilar aneurysm surgery. The use of spontaneous ventilation. Anesthesiology 77:681–685, 1992

    Article  CAS  PubMed  Google Scholar 

  30. Wilson CB, Spetzler RF: Factors responsible for improved results in the surgical management of intracranial aneurysms and vascular malformations. Am J Surg 134:33–38, 1977

    Article  CAS  PubMed  Google Scholar 

  31. Drummond JC: Deliberate hypotension for intracranial aneurysm surgery: Changing practices (Letter to the editor). Can J Anaesth 38:935–936, 1991

    Article  CAS  PubMed  Google Scholar 

  32. Craen RA, Gelb AW, Eliasziw M, Lok P: Current anesthetic practices and use of brain protective therapies for cerebral aneurysm surgery at 41 North American centers. J Neurosurg Anesth 6:303, 1994

    Google Scholar 

  33. Samson DS, Batjer HH, Bowman G, et al: A clinical study of the parameters and effects of temporary arterial occlusion in the management of intracranial aneurysms. Neurosurgery 22–29, 1994

    Google Scholar 

  34. Young WL, Solomon RA, Pedley TA, et al: Direct cortical EEG monitoring during temporary vascular occlusion for cerebral aneurysm surgery. Anesthesiology 71:794–799, 1989

    Article  CAS  PubMed  Google Scholar 

  35. Taniguchi M, Nadstawek J, Pechstein U, Schramm J: Total intravenous anesthesia for improvement of intraoperative monitoring of somatosensory evoked potentials during aneurysm surgery. Neurosurgery 31:891–897, 1992

    Article  CAS  PubMed  Google Scholar 

  36. Stone JG, Young WL, Marans ZS, et al: Cardiac performance preserved despite thiopental loading. Anesthesiology 79:36–41, 1993

    Article  CAS  PubMed  Google Scholar 

  37. Stein BM, Wolpert SM: Arteriovenous malformations of the brain: I. Current concepts and treatment. Arch Neurol 37:1–5, 1980

    Article  CAS  PubMed  Google Scholar 

  38. Kader A, Young WL, Pile-Spellman J, et al: The influence of hemodynamic and anatomic factors on hemorrhage from cerebral arteriovenous malformations. Neurosurgery 34:801–808, 1994

    Article  CAS  PubMed  Google Scholar 

  39. Young WL, Pile-Spellman J: Anesthetic considerations for interventional neuroradiology (Review). Anesthesiology 80:427–456, 1994

    Article  CAS  PubMed  Google Scholar 

  40. Sisti MB, Kader A, Stein BM: Microsurgery for 67 intracranial arteriovenous malformations less than 3 cm in diameter. J Neurosurg 79:653–660, 1993

    Article  CAS  PubMed  Google Scholar 

  41. Spetzler RF, Wilson CB, Weinstein P, et al: Normal perfusion pressure breakthrough theory. Clin Neurosurg 25:651–672, 1978

    CAS  PubMed  Google Scholar 

  42. Young WL, Ornstein E, Baker KZ, et al: Cerebral hyperemia after AVM resection is related to “break-through” complications but not to feeding artery pressure (abstract). Anesth Analg 80:S573, 1995

    Google Scholar 

  43. Young WL, Pile-Spellman J, Prohovnik I, et al: Evidence for adaptive autoregulatory displacement in hypotensive cortical territories adjacent to arteriovenous malformations. Neurosurgery 34:601–611, 1994

    Article  CAS  PubMed  Google Scholar 

  44. Young WL, Kader A, Ornstein E, et al: Cerebral hyperemia after arteriovenous malformation resection is related to “breakthrough” complications but not to feeding artery pressure. Neurosurgery 38:1085–1095, 1996

    CAS  PubMed  Google Scholar 

  45. Bloomfield EL, Porembka DT, Ebrahim ZY, et al: Analysis of catecholamine and vasoactive peptide release in intracranial arterial venous malformations. J Neurosurg Anesth 8:101–110, 1996

    Article  CAS  Google Scholar 

  46. McFarlane R, Moskowitz MA, Sakas DE, et al: The role of neuroeffector mechanisms in cerebral hyperperfusion syndromes (Review). J Neurosurg 75:845–855, 1991

    Article  Google Scholar 

  47. Ravussin P, Tempelhoff R, Modica PA, Bayer-Berger M-M: Propofol vs. thiopental-isoflurane for neurosurgical anesthesia: Comparison of hemodynamics, CSF pressure, and recovery. J Neurosurg Anesth 3:85–95, 1991

    Article  CAS  Google Scholar 

Download references

Authors
  1. William L. Young MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eugene Ornstein PhD MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ze’ev Shenkman MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shailendra Joshi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, The University of Utah School of Medicine, Salt Lake City, Utah, USA

    J. O. Johnson MD, PhD , R. J. Sperry MD, PhD  & T. H. Stanley ,  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Young, W.L., Ornstein, E., Shenkman, Z., Joshi, S. (1997). Anesthesia for Cerebrovascular Surgery. In: Johnson, J.O., Sperry, R.J., Stanley, T.H. (eds) Neuroanesthesia. Developments in Critical Care Medicine and Anesthesiology, vol 32. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5774-2_22

Download citation

  • DOI: https://doi.org/10.1007/978-94-011-5774-2_22

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6437-8

  • Online ISBN: 978-94-011-5774-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation