ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Delayed ischaemic deficits induced by cerebral arterial vasospasm are the most common postbleed complications and are the most important causes of death and severe disability in patients with subarachnoid haemorrhage. In spite of extensive clinical and experimental investigations in recent years, the basic pathophysiology of cerebral arterial vasospasm after subarachnoid haemorrhage remains uncertain, and treatment modalities for symptomatic cerebral arterial vasospasm are controversial. Successful treatment has been achieved with a wide variety of drug and interventional regimens. However, few of these preventive and therapeutic strategies have been evaluated in prospective, randomized, controlled trials. The therapeutic approaches for delayed neurological complications due to cerebral vasospasm after subarachnoid haemorrhage include haemodynamic augmentation, balloon dilatation angioplasty, intra-aortic balloon counterpulsation, and the use of drugs such as calcium-channel blockers, antioxidants, thrombolytic agents, endothelin receptor antagonists and papaverine. In the absence of firm guidelines for the clinician about postoperative treatment strategies, a graded treatment protocol in which volume expansion and induced hypertension are the mainstays is presented.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Awake craniotomy allows functional assessment and electrocorticography during resection of brain tissue adjacent to the functionally important areas of the cerebral cortex. This review outlines some of the anaesthetic considerations for awake craniotomy, and highlights the recent literature in this area that has focused on outcome following epilepsy surgery, and the electrophysiological effects of propofol.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Neurocysticercosis is the most common parasitic disease in the central nervous system. In the past considered rare in industrialized countries, substantial immigration from endemic areas has caused a significant increase in prevalence. Neurocysticercosis is the main cause of late-onset epilepsy and a major cause of several neurological disorders. The aim of this review is to present the characteristics of this disease relevant to anesthesiologists to improve their knowledge of neurocysticercosis and its complications.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This review focuses on the concerns that underlie anesthesia for posterior fossa surgery. It discusses the perioperative evaluation of the patient, selection of intraoperative monitors, the choice of anesthetic technique and drugs, potential intraoperative complications, and care at emergence from anesthesia and in the postoperative period.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Several techniques for intraoperative monitoring of spinal cord motor tracts have been developed recently. The aim of this review is to describe the essentials of these techniques, recent advances and the indications and limitations of the various modalities. While transcranial cortical stimulation with recording of myogenic responses is entirely specific for motor tract conduction, it is also the most challenging motor tract monitoring technique in terms of anaesthetic management, because it is incompatible with high concentrations of volatile agents and requires careful titration of neuromuscular blocking drugs. Nerve action potentials recorded following high thoracic spinal cord stimulation are robust even in the presence of 1 minimal alveolar concentration of isoflurane or desflurane, but the recorded signal may not be entirely specific for motor tract conduction. Multi-pulse stimulation paradigms appear to improve the amplitude and reproducibility of motor-evoked potentials in response to both transcranial and spinal cord stimulation. The use of these techniques will probably improve the success rate and reliability of intraoperative motor-evoked potential monitoring.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Work during the past year on monitoring of the nervous system is reviewed, with specific focus on advances in sensory- and motor-evoked potentials, near-infrared spectroscopy, transcranial Doppler, and electroencephalographic techniques to detect awareness under anesthesia. For techniques where a proven relationship to outcome exists (somatosensory-evoked potentials in scoliosis surgery and facial nerve monitoring during vestibular schwannoma resection), recent advances have revolved around enhancements of the technique to improve its usefulness. For transcranial Doppler sonography and near-infrared spectroscopy, recent work has attempted to demonstrate the relationship of the monitoring to changes in the physiological variable of greater interest which cannot in themselves be directly measured (blood flow and cerebral oxygenation, respectively). Finally, studies with the bispectral index, derived from the electroencephalogram, continue to make slow progress in finding the elusive measure of awareness under anesthesia. This review clearly defines the clinical utility of some of these techniques, giving impetus to further studies in their application.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID