• W Scott Jellish.
• Department of Anesthesiology, Loyola University Medical Center, 2160 South First Avenue, Building 103-Room 3114, Maywood, IL 60153, USA. wjellis@lumc.edu
• Neurol Clin. 2006 Nov 1; 24 (4): 647-59, viii.

AbstractPatients who have cerebrovascular disease and vascular insufficiency routinely have neurosurgical and nonneurosurgical procedures. Anesthetic priorities must provide a still bloodless operative field while maintaining cardiovascular stability and renal function. Patients who have symptoms or a history of cerebrovascular disease are at increased risk for stroke, cerebral hypoperfusion, and cerebral anoxia. Type of surgery and cardiovascular status are key concerns when considering neuroprotective strategies. Optimization of current condition is important for a good outcome; risks must be weighed against perceived benefits in protecting neurons. Anesthetic use and physiologic manipulations can reduce neurologic injury and assure safe and effective surgical care when cerebral hypoperfusion is a real and significant risk.

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