Principles of neuroanesthesia in stroke surgery

Abstract

Subarachnoid hemorrhage (SAH) is a devastating disease with a high incidence of morbidity and mortality. The main aims of therapy are the prevention of rebleeding and the prevention and treatment of delayed cerebral ischemia. SAH is manifested with a variable combination of symptoms and is accompanied by various systemic disturbances, such as cardiac arrhythmias and insufficiency, neurogenic pulmonary edema, and electrolyte disorders. Successful perioperative treatment - apart from the surgical and endovascular techniques - requires solid knowledge and understanding of the regulation of cerebral hemodynamics, and the effects of subarachnoid hemorrhage and other diseases and various drugs, including the anesthetic agents, on it. In the following, the basic principles of neuroanesthesia for patients with SAH are reviewed. © 2010 Springer-Verlag/Wien.