Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Oct 2011
Perioperative management of children with encephalocele: an institutional experience.
Encephaloceles are neural tube defects that are characterized by protrusion of the brain and meninges through a defect in the cranium. The inherent implications of pediatric anesthesia and difficult airway make surgical correction challenging for anesthesiologists ⋯ Difficult airway is not the only concern in children with encephalocele, but associated congenital malformations, hydrocephalus, large size of sac, and hemodynamic disturbances all require careful consideration.
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J Neurosurg Anesthesiol · Oct 2011
The effects of insulin, glucagon, glutamate, and glucose infusion on blood glutamate and plasma glucose levels in naive rats.
Elevated levels of glutamate in brain fluids, in the context of several neurodegenerative conditions, are associated with a worsened neurological outcome. Because there is a clear relationship between brain glutamate levels and glutamate levels in the blood, and an association of the latter with stress, the purpose of this study was to investigate the effects of glucose, insulin, and glucagon on rat blood glutamate levels. ⋯ The results of this study demonstrate that glucose, insulin, and glucagon significantly reduce blood glutamate levels. The effect of insulin is immediate and transient, whereas the effect of glucagon is delayed but longer lasting, suggesting that the sensitivity of pancreatic glucagon and insulin-secreting cells to glutamate is dependent on glucose concentration. The results of this study provide insight into blood glutamate homeostasis and may assist in the implementation of new therapies for brain neuroprotection from excess glutamate.
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J Neurosurg Anesthesiol · Jul 2011
Case ReportsFeasibility of intraoperative MRI guidance for craniotomy and tumor resection in the semisitting position.
Intraoperative magnetic resonance imaging (iMRI) has emerged as a reliable and useful tool in intracranial brain tumor surgery. Patient placement in a semisitting position may be advantageous in certain cases, but has so far seemed incompatible with conductance of iMRI-guided procedures. ⋯ The iMRI-guided brain tumor resection is feasible in combination with semisitting patient positioning. However, special safety precautions must be followed.