Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2022
Pituitary Dysfunction After Aneurysmal Subarachnoid Hemorrhage: A Prospective Cohort Study.
The prevalence of pituitary dysfunction after aneurysmal subarachnoid hemorrhage (aSAH) remains incompletely elucidated. Furthermore, it is not clear whether these abnormalities impact patient outcomes. The aim of this study was to evaluate the prevalence of pituitary dysfunction after aSAH and its effect on outcomes. ⋯ Pituitary dysfunction is common after aSAH, but does not affect 6 to 12-month clinical outcomes.
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J Neurosurg Anesthesiol · Jan 2022
Feasibility of Full Neuromuscular Blockade During Transcranial Motor Evoked Potential Monitoring of Neurosurgical Procedures.
Transcranial motor evoked potential (TcMEP) monitoring is conventionally performed during surgical procedures without or with minimal neuromuscular blockade (NMB) because of its potential interference with signal interpretation. However, full blockade offers increased anesthetic management options and facilitates surgery. Here, the feasibility of TcMEP interpretation was assessed during full NMB in adult neurosurgical patients. ⋯ TcMEP interpretation may be feasible under greater levels of NMB than previously considered, allowing for monitoring with greater degrees of muscle relaxation. Consideration for monitoring TcMEP during full NMB should be made on a case-by-case basis, and baseline responses without blockade may predict which patients will have adequate responses for interpretation.
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J Neurosurg Anesthesiol · Jan 2022
Awake Craniotomy Under 3-Tesla Intraoperative Magnetic Resonance Imaging: A Retrospective Descriptive Report and Canadian Institutional Experience.
The role of high-field 3-Tesla intraoperative magnetic resonance imaging (I-MRI) during awake craniotomy (AC) has not been extensively studied. We report the feasibility and safety of AC during 3-Tesla I-MRI. ⋯ Our institutional experience suggests that AC under 3-Tesla I-MRI could be an option for glioma resection, although firm conclusions cannot be drawn given the limited and heterogenous nature of our data. Future multicenter trials comparing anesthetic and imaging modalities for glioma resection are recommended.
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J Neurosurg Anesthesiol · Jan 2022
Arterial and Venous Cerebral Blood Flow Velocities and Their Correlation in Healthy Volunteers and Traumatic Brain Injury Patients.
Few studies have explored the cerebral venous compartment or the correlation between venous and arterial cerebral blood flows. We aimed to correlate cerebral blood flow velocities in the arterial (middle cerebral artery) and venous (straight sinus) compartments in healthy volunteers and traumatic brain injury (TBI) patients. In addition, we determined the normative range of these parameters. ⋯ There are age and sex differences in arterial and venous cerebral blood flow velocities in healthy volunteers. Arteriovenous correlation is present in healthy volunteers but absent in TBI patients.
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J Neurosurg Anesthesiol · Jan 2022
Observational StudyImpact of Ventilator-associated Pneumonia on Cerebrospinal Fluid Inflammation During Immunosuppression After Subarachnoid Hemorrhage: A Pilot Study.
Brain injuries can cause systemic immunosuppression, which in turn can lead to infections that adversely affect the injured brain and worsen clinical outcomes. This study aimed to investigate whether systemic infection, such as ventilator-associated pneumonia (VAP), induce intracranial inflammation in patients with subarachnoid hemorrhage (SAH). ⋯ VAP increased intracranial inflammatory responses in patients with SAH despite the occurrence of systemic immunosuppression. A better understanding of cell trafficking and their pleiotropic functions in brain injury is needed to define the optimal strategies for preventing infections in patients with SAH.