Journal of neurosurgical anesthesiology
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Aneurysmal subarachnoid hemorrhage (SAH) is a worldwide health burden with high fatality and permanent disability rates. The overall prognosis depends on the volume of the initial bleed, rebleeding, and degree of delayed cerebral ischemia (DCI). Cardiac manifestations and neurogenic pulmonary edema indicate the severity of SAH. ⋯ DCI is an important cause of morbidity and mortality following SAH, and the pathophysiology is likely multifactorial and not yet understood. At present, oral nimodipine has an established role in the management of DCI, along with maintenance of euvolemia and induced hypertension. Following SAH, hypernatremia, although less common than hyponatremia, is a predictor of poor neurological outcome.
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J Neurosurg Anesthesiol · Jul 2015
A New Method of Airway Management in Patients Undergoing Gasserian Ganglion Thermal Coagulation: Preliminary Results.
Airway management in patients undergoing neurosurgical interventions for trigeminal neuralgia can often prove difficult. This is because the patient's assistance is required during this neurosurgical intervention, and moreover, the site of puncture lies within the working area of the anesthesiologists. An obvious alternative for airway management is the use of a nasopharyngeally placed tube. The purpose of the present study was to objectify the gas exchange in patients during this new ventilation technique. ⋯ This preliminary study suggests that manually assisted ventilation with pure oxygen using a nasopharyngeally placed tube seems to be a sufficient airway management technique during thermal coagulation of the Gasserian ganglion.
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J Neurosurg Anesthesiol · Jul 2015
The Monitoring and Management of Severe Traumatic Brain Injury in the United Kingdom: Is there a Consensus?: A National Survey.
To survey the current practice of monitoring and management of severe traumatic brain injury (TBI) patients in the critical care units across the United Kingdom. ⋯ We identified that there was no clear consensus and considerable variation in practice in the management of TBI patients in UK neurocritical care units. A protocol-based management has been shown to improve outcome in sepsis patients. Given the magnitude of the problem, we conclude that there is an urgent need for international consensus guidelines for management of TBI patients in critical care units.