Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Oct 2016
Cerebral Blood Flow Measurement by Near-Infrared Spectroscopy During Carotid Endarterectomy.
It is crucial to evaluate cerebral blood flow (CBF) during carotid endarterectomy (CEA). However, it is difficult to measure CBF in the operating room. The recent development of high-accuracy near-infrared spectroscopy (NIRS) has enabled the measurement of regional CBF following injection of indocyanine green (ICG). We aimed to measure changes in regional CBF by clamping the carotid artery during CEA and to analyze factors affecting the blood flow index (BFI) in CEA. ⋯ The BFI was significantly reduced by carotid artery clamping during CEA. Abnormalities of the circle of Willis were a significant factor contributing to reduced BFI.
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J Neurosurg Anesthesiol · Oct 2016
Intracarotid Etomidate Decreases the Interhemispheric Synchronization in Electroencephalogram (EEG) During the Wada Test.
The Wada test is a diagnostic method to anesthetize 1 cerebral hemisphere and assess the language and memory functions of awake contralateral hemisphere before temporal lobectomy in patients with epilepsy. The effects of an ipsilateral injection of etomidate on the functional properties of contralateral hemisphere are not known. Our aim was to characterize the electroencephalographic (EEG) effects after intracarotid injection of etomidate and to determine the changes in synchronization between the ipsilateral and contralateral hemispheres. ⋯ Our study showed that the EEG effects of intracarotid ipsilateral injection of etomidate is not uniform in both hemispheres. Decrease in the interhemispheric synchronization of delta waves might serve as an indicator of ipsilateral effect of etomidate on the brain. Additional studies are needed to confirm our findings.
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J Neurosurg Anesthesiol · Oct 2016
Meta AnalysisPhysical Activity and Cognitive Development: A Meta-Analysis.
Is there an association between regular exercise, defined as a structured program of increased physical activity at least 1 month in duration, and improvements in measures of executive functions compared with children who engage in their normal daily activities? ⋯ Increased regular physical activity is associated with a small and measurable, improvement in neuropsychological tests of executive functions, specifically inhibitory control. Executive functions play an important role in complex behavior, and may contribute to academic and career achievement as well as success in social interaction. This finding provides support for the important interaction between exercise and cognitive functioning.
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J Neurosurg Anesthesiol · Oct 2016
ReviewOptimal Timing of Surgical Procedures in Pediatric Patients.
The Pediatric Anesthesia Neuro Development Assessment (PANDA) team at the Anesthesiology Department at Columbia University Medical Center held its fifth biennial symposium to discuss issues regarding potential neurotoxicity of anesthetic agents in pediatric patients. Overall optimal surgical timing as well as a "critical window" for surgery on a specialty specific basis are areas of focus for the American Academy of Pediatrics Surgical Advisory Panel. An ad hoc panel of pediatric surgical experts representing general surgery, urology, neurosurgery, and ophthalmology was assembled for this meeting and provided a dialogue focused on the benefits of early intervention versus potential anesthetic risk, addressing parental concerns, and the need for continued interdisciplinary collaboration in this area.