Venous Air Embolism in Neuro Surgery (VAE) Rate of occurrence of VAE depand on Procedure Intra-operative Position Method of detection Associated – principally hazard of post. fossa procedures Surgery → performed in sitting position and upper cervical spine Can occur with supratentorial procedures like facine menigiomas encroaching post. half of sagital sinus, craniosynostosis. Pin sites […]

Contemporary management of intracranial aneurysm after Sub arachnoid haemorrhage (SAH) calls for early intervention Early – within 72 hrs of SAH Ultra early → within 18 hrs of SAH Intervention applied to I to IV grades of “world federation of neurosurgeons SAH scale”( WFNS) or I to III of “hunt –Hess classification” WFNS classification → […]

Effects of Anaesthetic agents on cerebral Physiology Most general anaesthetics have favourable effect on the CNS by reducing electrical Activity Carbohydrate metabolism energy stores in the form of ATP, phosphocreatine & ADP ↑ Effect of specific agent is complicated by concomitant administration of other drugs and ➤ Surgical stimulation ➤ Intracranial compliance ➤ BP ➤ […]

Intracranial pressure[ICP] and its significance  – Definition– intracranial pressure by convention means supratentorial  CSF pressure measured in the lateral ventricles or over cerebral cortex. Normal range- 8-12 mm of Hg. Cranial vault is rigid structure with fixed total volume- 1.brain -80% 2.blood -12% 3.CSF –  8%     [increase in any component increases ICP]. INTRACRANIAL COMPLIANCE -Change […]

  Circle of Willis   Common carotid origin ☛ Rt common carotid from Rt brachiocepholic trunk ☛ Lt common carotid from Arch of aorta ☛ In neck they travel in carotid sheath ☛ At level of thyroid cartilage they divide into external & internal carotid A. ☛ Internal carotid A passes through neck to enter […]