Journal of neurosurgical anesthesiology
-
J Neurosurg Anesthesiol · Aug 2024
Rapid Ventricular Pacing for Clipping of Intracranial Aneurysms: A Single-centre Retrospective Case Series.
Multiple strategies exist to facilitate microdissection and obliteration of intracranial aneurysms during microsurgical clipping. Rapid ventricular pacing (RVP) can be used to induce controlled transient hypotension to facilitate aneurysm manipulation. We report the indications and outcomes of intraoperative RVP for clipping of ruptured and unruptured complex aneurysms. ⋯ This retrospective case series suggests that RVP could be an effective adjunct for clipping of complex ruptured and unruptured aneurysms, associated with transient troponin rise but rare postoperative cardiac complications.
-
J Neurosurg Anesthesiol · Aug 2024
Brain and Heart Interactions Delineating Cardiac Dysfunction in Four Common Neurological Disorders: A Systematic Review and Meta-analysis.
Neurological and cardiovascular disorders are the leading causes of morbidity and mortality worldwide. While the effects of cardiovascular disease (CD) on the nervous system are well understood, understanding of the reciprocal relationship has only recently become clearer. Based on disability-adjusted life years, this systematic review and meta-analysis present the pooled incidence and association of CD in 4 selected common, noncommunicable neurological disorders: (1) migraine, (2) Alzheimer disease and other dementias, (3) epilepsy, and (4) head injury. ⋯ Epilepsy was associated with the greatest increased odds of developing CD (odds ratio: 2.25; 95% CI: 1.82-2.79; P = 0.04). In studies that reported this variable, the pooled hazard ratio was 1.64 (95% CI: 1.38-1.94), with head injury having the highest hazard ratio (2.17; 95% CI: 1.30-3.61). Large prospective database studies are required to understand the long-term consequences of CD in patients with neurological disorders.
-
J Neurosurg Anesthesiol · Jul 2024
To the Brain and Beyond: Neurological Implications of Glucagon-Like Peptide-1 Receptor Agonists.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as an increasingly popular class of medications commonly used for glycemic control in patients with type 2 diabetes mellitus and for weight loss. GLP-1 RAs also have potential benefits in patients with various neurological diseases independent of their glucose-modulating effect. In this focused review, we explore animal and clinical evidence evaluating the impact of GLP-1 RAs in common neurological diseases. Our aim is to provide a basis for hypothesis generation for future studies to assess the role that GLP-1 RAs may have on the nervous system, including implications for the perioperative period.
-
J Neurosurg Anesthesiol · Jul 2024
Outcome of Aneurysmal Subarachnoid Hemorrhage Not Altered With Transatlantic Airplane Transfer: A Bicentric Matched Case-control Study.
It is recommended that ruptured cerebral aneurysms are treated in a high-volume center within 72 hours of ictus. We assessed the impact of long-distance aeromedical evacuation in patients presenting aSAH. ⋯ Long-distance aeromedical evacuation of patients with aSAH from Guadeloupe to Paris resulted in a 25-hour increase in time to aneurysm coiling embolization time but did not impact 1-year functional outcomes or mortality.