Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Apr 2011
ReviewMoyamoya disease: a review of the disease and anesthetic management.
Moyamoya disease is a rare chronic cerebrovascular disease seen both in children and adults. It has a progressive course, but may have a variable clinical presentation. The disease causes ischemic stroke, intracranial hemorrhage, headache, seizures, and transient ischemia attack in children and in adults. ⋯ These have specifically resulted from the identification of risk factors for perioperative complications and outcomes related to the use of anesthetic agents. Finally, research in the last 3 decades has led to the recognition of the importance of pain control, the increased use of regional anesthesia, and better monitoring techniques in providing high quality and safe patient care to patients with Moyamoya disease. This article will provide a comprehensive review of the disease and its anesthetic management.
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J Neurosurg Anesthesiol · Apr 2011
Do patients still require admission to an intensive care unit after elective craniotomy for brain surgery?
After elective craniotomy for brain surgery, patients are usually admitted to an intensive care unit (ICU). We sought to identify predictors of postoperative complications to define perioperative conditions that would safely allow ICU bypass. ⋯ Our results encourage prospectively testing the hypothesis that patients with immediate, successful tracheal extubation after elective craniotomy for brain surgery, with a surgical duration of less than 4 hours in a nonlateral position could be monitored safely in the postanesthesia care unit before being discharged to a neurosurgical ward.
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J Neurosurg Anesthesiol · Apr 2011
Effects of propofol on electrocorticography in patients with intractable partial epilepsy.
Propofol's potential to trigger generalized tonic-clonic seizures and epileptic discharges is still controversial. The aim of this study was to investigate the incidence of epileptic discharges and epileptic seizures in epilepsy patients anesthetized with propofol. ⋯ Our results do not contraindicate the use of propofol in patients with partial epilepsy. While spike-burst-suppression-patterns were recorded under propofol, the small number of surgically treated patients limits conclusions concerning their predictive value for improved epilepsy surgery outcome.
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J Neurosurg Anesthesiol · Apr 2011
Spatial memory using active allothetic place avoidance in adult rats after isoflurane anesthesia: a potential model for postoperative cognitive dysfunction.
We described a paradigm of active allothetic place avoidance (AAPA) as a measure of spatial memory in adult rats. We hypothesized that, pending successful AAPA training, treatment with isoflurane would trigger spatial memory deficits. ⋯ Control animals demonstrated increased active avoidance behavior in the AAPA task compared with isoflurane-treated animals. Animals exposed to 2-hour isoflurane general anesthetic had a reduction in the maximum path of avoidance measure up to 7 days postanesthesia, whereas gross spatial parameters such as number of entrances into the shock zone were not significantly different between groups. The AAPA model may prove useful in ascertaining the learning and memory deficits of postoperative cognitive dysfunction.