Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 1996
Case ReportsUnilateral blindness due to patient positioning during cervical syringomyelia surgery: unilateral blindness after prone position.
During spinal surgery using a horseshoe headrest with the patient in the prone position, the possibility of central retinal artery occlusion (CRAO) increases, and its cause can be attributed primarily to excessive extraocular pressure, a very rare complication. This report describes a case of CRAO, occurring in an adult, after cervical syringomyelia surgery in which a horseshoe headrest was used.
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J Neurosurg Anesthesiol · Jul 1996
Comparative StudyChanges in cerebral blood flow velocity in children during sevoflurane and halothane anesthesia.
The purpose of this study was to evaluate arterial blood pressure and middle cerebral artery blood flow velocity in children during induction of anesthesia with sevoflurane. These measures were compared to findings in a control group anesthetized with halothane. Each child received mask induction of sevoflurane (n = 9) or halothane (n = 9) with 70% nitrous oxide in oxygen. ⋯ Both sevoflurane (2.4%) and halothane (1.3%) combined with 70% nitrous oxide decreased blood pressure and increased cerebral blood flow velocity. Intubation increased blood pressure and further increased cerebral blood flow velocity with both anesthetic treatments. These results indicate that sevoflurane and halothane combined with nitrous oxide decrease blood pressure and increase cerebral blood flow velocity and suggest that sevoflurane produces cerebrovascular effects similar to those of halothane during anesthetic induction.
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J Neurosurg Anesthesiol · Jul 1996
Case ReportsConventional multimodality monitoring and failure to detect ischemic cerebral blood flow.
We report a case of cerebral infarction following traumatic brain injury associated with low cerebral blood flow, but not detected by measurements of jugular venous oxygen saturation, cerebral lactate production, cerebral perfusion pressure, transcranial Doppler ultrasound, or measures of systemic hemodynamics.
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J Neurosurg Anesthesiol · Apr 1996
Clinical TrialBrain relaxation and cerebrospinal fluid pressure during craniotomy for resection of supratentorial mass lesions.
Neurosurgery can be complicated by the clinical situation commonly referred to as "tight brain," in which the brain presses against the inner table of the skull or protrudes through the craniotomy site. We report here a retrospective study of 32 patients who had undergone elective craniotomy for resection of supratentorial mass lesions. We determined the relationship between lumbar cerebrospinal fluid pressure (CSFP) and brain relaxation and whether brain relaxation varies with anesthetic technique. ⋯ We conclude that in patients undergoing elective craniotomy for resection of a supratentorial mass lesion, brain relaxation is not predictive of CSFP. Although CSFP values at the extremes of the observed distribution ( > 17 mm Hg or < 6 mm Hg) did correlate with brain relaxation, within the range of 6-17 mm Hg, CSFP did not predict brain relaxation. Additionally, the data from this study suggest that in patients undergoing elective craniotomy for resection of a supratentorial mass lesion, tight brain may occur with a lower frequency in patients receiving 0.5 MAC ISO or DES with 50% N2O than in patients receiving 1 MAC ISO or DES.