Neurological: Cerebral Aneurysm

Abstract

In this chapter the essential aspects of anesthesia for resection of a cerebral aneurysm are discussed. Subtopics include the different types of aneurysms and strategies for preventing rupture, including nimodipine use and triple H therapy. The case presented involves a patient emergently scheduled for subarachnoid hemorrhage evacuation and intracranial aneurysm clipping. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Preoperative topics discussed are neurological and cardiac assessment, including cerebral blood flow and how hypertension affects anesthetic preparation. Issues regarding intraoperative management include induction, monitors used, and blood pressure control. Postoperative concerns addressed include rebleeding and vasospasm and hyponatremia.