Index_2017_Essentials-of-Neuroanesthesia

Prévia do material em texto

997
Index
‘Note: Page numbers followed by “f” indicate figures, “t” indicate tables and “b” indicate boxes.’
A
A Randomized Trial of Unruptured Brain 
Arteriovenous malformations trial 
(ARUBA trial), 353–354
A waves, 66, 142
A-VO2. See Arteriovenous oxygen difference 
(AjvDO2)
AAA technique. See Asleep-awake-asleep 
technique (AAA technique)
AADI. See Anterior atlas–dental interval 
(AADI)
AAI. See Atlantoaxial instability (AAI)
AB-5C protocol, 237
ABCS sequence. See Alignment, bones, 
cartilages, soft tissues sequence 
(ABCS sequence)
ABG. See Arterial blood gas (ABG)
ABP. See Arterial blood pressure (ABP)
Absolute contraindications, 279
AC. See Awake craniotomy (AC)
ACA. See Anterior cerebral artery (ACA)
ACC. See American College of Cardiology 
(ACC)
ACD. See Anterior cervical diskectomy (ACD)
ACE inhibitors. See Angiotensin-converting 
enzyme inhibitors (ACE inhibitors)
Acetaminophen, 845
Acetazolamide-responsive myotonia, 756
Acetylcholine (ACh), 291, 662, 738
Acetylcholine receptor (AChR), 735
Acetylcholinesterase inhibitors, 739
AChesterase. See Anti-Acetylcholinesterase 
(AChesterase)
Achondroplasia, 412
AChR. See Acetylcholine receptor (AChR)
ACHs. See Air change rates (ACHs)
ACLS. See Advanced cardiopulmonary life 
support (ACLS)
ACom. See Anterior communicating artery 
(ACom)
Acoustic area, 11
Acromegaly, 382–383
ACS-NSQIP universal surgical risk 
calculator, 211
ACT. See Activated clotting time (ACT)
ACTH. See Adrenocorticotropic hormone 
(ACTH)
Activated clotting time (ACT), 511
Acute angle closure glaucoma, 202, 202t–203t
Acute brain injury, 800
Acute headache attributed to craniotomy, 839
Acute heart failure, 694
Acute hematoma, 457
Acute hemorrhagic infarction of pituitary, 
395–397
Acute hospital care, 551–558
monitoring in TBI, 551–552, 552t
surgical treatment of head injury, 552–553, 
553t
Acute hypocortisolism, 395
Acute inflammatory demyelinating 
polyradiculoneuropathy (AIDP), 749
Acute injury, management for, 567–578
initial prehospital assessment and 
management, 567–570
Acute ischemic stroke (AIS), 515
Acute motor axonal neuropathy (AMAN), 749
Acute motor–sensory axonal neuropathy, 749
Acute pain
management after spinal surgery, 843–844
treatment, 840–843
Acute phase, 564, 564t
Acute postoperative pain, 836, 844, 846
Acute postoperative spinal pain, treatment 
modalities for
α2-adrenoreceptor antagonists, 847
corticosteroids, 845
epidural drug administration, 846–847
gabapentin, 845–846
intrathecal drug administration, 846
intravenous PCA, 846
ketamine, 845
newer modalities, 847
NSAIDs, 844–845
Acute respiratory failure, 776
AD. See Alzheimer disease (AD)
Adaptive autoregulatory displacement, 354
ADAs. See Antidiabetic agents (ADAs)
Adenosine, 341–342
Adenosine-assisted cerebral blood flow 
arrest, 370–372
anesthesia management, 371–372
case selection and indications, 370–371
complications and associated postop-
erative outcomes, 371
in neurosurgery, 370
Adenosine-induced circulatory arrest, 341, 
341t–342t
Adenosine-induced flow arrest, 356–357
ADH. See Antidiuretic hormone (ADH)
Adhesion molecules, 587
ADR. See Alpha/delta ratio (ADR)
β1-Adrenergic blocker metoprolol, 723
Adrenocorticotropic hormone (ACTH), 455
ACTH-secreting tumor, 381
secretion, 376
α2-Adrenoreceptor agonist, 842
α2-Adrenoreceptor antagonists, 847
Adult respiratory distress syndrome 
(ARDS), 556
Adult stem cells, 908
Advanced cardiopulmonary life support 
(ACLS), 704, 706
Advanced glycosylation end products (AGEs), 
715
Adverse effects
ACh inhibitors, 739
NMES, 776–777
Adynamia episodica hereditaria, 756
AE. See Antiepileptics (AE)
AEDs. See Antiepileptic drugs (AEDs)
Afferent fibers, 16
Age/aging, 838
body system, 653
in CBF, 73
AGEs. See Advanced glycosylation end 
products (AGEs)
Agitated saline, 270, 279
Agitation during emergence from 
anesthesia, 250
AHA. See American Heart Association (AHA)
AHA/ASA. See American Heart Association/
American Society of Anesthesiologists 
(AHA/ASA); American Heart 
Association/American Stroke 
Association (AHA/ASA)
AHI. See Apnea–Hypopnea Index (AHI)
AICDs. See Automated implantable cardiac 
defibrillators (AICDs)
AIDP. See Acute inflammatory demyelin-
ating polyradiculoneuropathy (AIDP)
AION. See Anterior ION (AION)
Air
emboli, 270–271
embolism, 280
entrainment, 264, 280
Air change rates (ACHs), 941
Airway, 237, 297
complications, 299
instrumentation, 295
intervention, 298
mechanics, 671
and respiratory mechanics, 671
spine mobility evaluation, 422–423
Airway management, 384, 386, 425–426, 451, 
493, 531, 555, 574–575, 577
considerations in patients with cervical 
spine disorders, 425
devices, techniques, and maneuvers, 
425–426
MC, 745–746
strategy, 425
AIS. See Acute ischemic stroke (AIS)
AjvDO2. See Arteriovenous oxygen 
difference (AjvDO2)
Index998
Alar plate, 48
Albumin, 645, 820–821, 829, 831
fluid evaluation study, 549–551
Albuminocytological dissociation, 751
Alfentanil, 290, 297
ALIF. See Anterior interbody fusion (ALIF); 
Anterior lumbar interbody fusion 
(ALIF)
Alignment, bones, cartilages, soft tissues 
sequence (ABCS sequence), 
571–572
ALL. See Anterior longitudinal ligament (ALL)
Alpha/delta ratio (ADR), 144
ALS. See Amyotrophic lateral sclerosis (ALS)
Alternative hypothesis (H1), 980
Alveolar enflurane, 289
Alzheimer dementia, 666
Alzheimer disease (AD), 54, 734, 763–764, 
784–785, 909, 955
anesthetic considerations, 784–785, 784t
effect
of anesthetic agents on disease 
progression, 785
of disease on anesthesia, 785
AMAN. See Acute motor axonal neuropathy 
(AMAN)
American Academy of Neurology Practice 
Parameter, 286
American College of Cardiology (ACC), 
211, 694–695
American Diabetes Association, 714
American Heart Association (AHA), 211, 
694–695
American Heart Association/American 
Society of Anesthesiologists (AHA/
ASA), 348, 883–884
American Heart Association/American 
Stroke Association (AHA/ASA), 
317, 600
American Psychiatric Association, 662
American Society of Anesthesiologists 
(ASA), 210, 212, 422–423, 443, 457, 
530, 698
Physical Status Classification System, 664
POVL registry, 443
practice advisory, 530–531
practice advisory on anesthetic care for 
MRI, 530–531
American Society of Regional Anesthesia 
and Pain Medicine anticoagulation 
guidelines, 689
American Spinal Injury Association (ASIA), 
561
impairment scale, 563, 563t
International Standards for neurological 
classification, 561–563
γ-Aminobutyric acid (GABA), 480, 532, 845
receptor, 55, 105, 124
γ-Aminobutyric acid type A (GABAA), 917
Aminoglycosides, 742
Amniogenic cells, 42
Amniotic cavity, 42
Amniotic fluid stem cells, 908
Amobarbital, 105
AMPA receptors, 311, 313
Amygdaloid body, 47
β-Amyloid protein, 127
Amyotrophic lateral sclerosis (ALS), 759, 788
anesthetic consideration, 788, 788t
Amyotrophic lateral sclerosis, 910
Analgesia, 556
Analgesics, 918–919
ARRB2, 918
COMT, 918
MCR1, 919
Mu(μ)-opioid receptor, 918
Anaphylaxis, 705
Anastomosis, 68
Anatomic/anatomy, 3–4
basis of pain following craniotomy, 
836–838
brain, 4–30, 5f
hemispherectomies, 301
posterior cranial fossa, 255–256
of spinal cord, 84
spinal injury on, 561
standardized resection, 286
surveillance, 448
Ancillary tests, 858–859
electroencephalogram, 858
evoked potentials, 859
four-vessel cerebral angiography, 859
heart rate variability, 859
radionucleotide studies, 859
transcranial doppler, 859
Andrew’s hinder–binder frame, 196, 196f
Anemia, 95–96, 422
Anesthesia, 127, 184–185, 189, 261, 291, 342, 
355–357, 364, 442, 473–474, 649, 661, 
671. See also Hypertension
anesthetic management of endovascular 
embolization, 513–514
care in neuroradiology, 506
clinical anesthesia, pharmacogenomics 
application to, 916–921
for computed tomographic study, 506
contribution to pharmacogenomics, 
915–916
CPR in neurosurgical patient, 708
depth of, 150–152
for diagnostic angiography, 510
for ECT, 806–809, 807t
effects
of AEDs on, 793, 793f
of disease, 785, 789–792
on endothelial cells, 53
on TJs, 52–53
emergence from, 240–241,386
for ES, 288
hypnotic component of anesthesia 
monitoring, 173–174
implication on elderly, 653, 654t
induction, 238–239, 631, 725–726
for interventional neurosurgical 
procedures, 679
for intracranial electrode insertion, 
294–295, 294f
for magnetic resonance imaging study, 
506–510
safety issues, 507
maintenance, 238–239, 631, 726
monitoring, 173–174
electrocorticography, 173
evoked potentials for monitoring 
nervous system integrity, 173
hypnotic component of anesthesia 
monitoring, 173–174
miscellaneous, 174–175
nociception monitoring, 174
for MRI, 530–531
neuroendocrine response to, 377
neuroinflammation and, 53–54
for neuroradiology, 505
and NO signaling, 52
in patients with deep brain stimulator in 
situ, 486
recovery from, 726
for stereotactic radiosurgery, 516
for stroke interventions, 514–515
technique, 214–217, 240, 332–333, 385–386
type of, 706
Anesthesia management, 247, 250, 328–329, 
340–341, 423–430
adenosine-assisted cerebral blood flow 
arrest
intraoperative management, 371
postoperative care, 372
preoperative assessment and 
preparation, 371
airway management, 425–426
anesthetic considerations for neuroelectro-
physiological monitoring, 427–428
anesthetic techniques, 332–333, 424–425
DHCA
intraoperative management, 368–370
postoperative care, 370
preoperative assessment and 
preparation, 368
for endovascular intracranial aneurysm 
ablation, 331–333
fluid and blood loss management, 
428–429, 428t
minimizing damage to spinal cord, 429–430
monitoring, 427–428
OLV, 426–427
RVP
intraoperative management, 372–373
postoperative care, 373
preoperative assessment and 
preparation, 372
Anesthesiologists, 222–223, 236, 277, 703, 
705, 709
Anesthesiology, 913
Anesthetic agents, 97–98, 146, 312, 839. 
See also Non-anesthetic agents
anesthesia and fragile brain, 127
clinical outcomes, 126–127
effect
in CBF, 73
of disease, 785–787
on disease progression, 785
on epilepsy, 794
on fetal outcome, 673–674
on MAG, 792–793
in patients with epilepsy, 288–290
teratogenic potential, 673–674
molecular mechanisms, 123–124
pharmacological considerations
Index 999
neuroprotection of anesthetic drugs, 
125–126
neurotoxicity of anesthetic drugs, 
124–125. See also Non-anesthetic 
agents
Anesthetic considerations, 481–484, 697
of AD, 784–785, 784t
of ALS, 788
for AVM embolization, 356–357
for AVM resection, 355–356
for DMD and BD, 758
drug interactions and effects, 482
epilepsy, 793–794, 794t
effect of AEDs on anesthesia, 
793, 793f
effect of anesthetic agents on epilepsy, 
794
of GBS, 789
of HD, 787–788, 787t
effect of disease on anesthetic agents, 
787–788
ICP, 351
intracranial tumors, 794–796
effect anesthetic agents on disease, 
796, 796t
of MAG, 791–793, 792t
MG, 740–743
anesthesia management, 742–743
preoperative evaluation and 
preparation, 740–741
response to anesthetic drugs, 
741–742
of MS, 789–791
of PD, 785, 786t
during posterior fossa craniotomy, 
257–258
during pregnancy, 675
premedication, 675
preoperative assessment and patient 
preparation, 482–484
problem in patients undergoing DBS, 
481, 482t
TBI, 797–798, 798f
Anesthetic drugs, 104, 288, 312
effects
anticholinergics and anticholinesterases, 
498
on electrocorticography monitoring, 
497–498
inhalational agents, 498
intravenous agents, 498
local anesthetics, 498
on neuroelectrophysiological 
monitoring, 420
neuromuscular blocking agents, 498
opioids, 498
Anesthetic management, 236–240, 261, 360, 
364, 698–699
on anesthetic care for MRI, 530–531
CVT, 689–690
emergency management of patients with 
supratentorial tumors, 236–237
management of patient with acute 
neurological deterioration, 237f
of endovascular coiling, 510–512
motor neuron diseases, 760
myotonias, 757–758
nonemergent management of patients 
with supratentorial tumors, 
237–238
of patient with epilepsy for incidental 
surgery, 302–303
of patients undergoing awake craniotomy, 
491b
of patients with head injury
with life-threatening extracranial injury, 
798, 799t
for non-life threatening extracranial 
injury, 799–800
of preoperative procedures, 292–293
of resection of seizure focus, 295
of specific neuroendoscopic procedures, 
453–466
endoscopic spinal fusion/ 
microdisectomy, 463–464, 463f
endoscopic strip craniectomy, 459–461, 
460t–461t
endoscopic third ventriculostomy, 
453–454, 453f–454f
endoscopic transsphenoidal 
hypophysectomy, 455
endoscopic-assisted clipping of 
aneurysms, 461
endoscopic-assisted skull base surgery, 
457–458
endscopic tumor excision/cyst 
fenestration, 458–459
minimally invasive DBS, 464–466, 465f
percutameous kyphoplasty/ 
vertebroplasty, 466
types of approach, 455–457
Anesthetic(s), 51, 297
anesthetic-related seizures, 288
care
for MRI, 530–531
of patients, 897
cellular and molecular effects, 52–54
clinical and experimental implications, 
54–56
concerns, 302
in acute SCI, 577–578
induction, 577
intubation for unstable cervical spine, 575t
neuromuscular blocking agents, 577
equipment, 936
evaluation, 237–238
goals and management
considerations, 450
intraoperative concerns, 451–452
postoperative considerations, 453
preoperative checkup, 450–451
history, 656
induction, 261, 302
inhalational, 289
intravenous, 289–290
neurotoxicity, 899–900
preconditioning, 97–98, 901
procedure, 473–475
regime, 297–300
AAA technique, 297–298, 298t
complications, 299
local anesthesia, 297
techniques, 248–250, 295, 424–425, 
484–485, 492–493, 497
AAA technique, 485
asleep-awake-asleep, 493
balanced anesthesia, 249
conscious sedation, 485, 492–493
dexmedetomidine, 249–250
general anesthesia, 424
LA of scalp, 485
monitored anesthesia care, 425
nonpharmacological measures, 493
and recovery of cognitive function, 249
regional anesthesia, 424–425
total intravenous anesthesia, 249
Aneurysm, 316, 326, 649
clipping, 342
hemorrhage, 670
occlusion, 327
repair procedures, 708
rupture, 328, 330
surgery, 327, 657
Aneurysmal SAH (aSAH), 316–317
brain relaxation, 329
clinical presentation, 317–319
diagnosis, 317, 318f
LP, 318–319, 319f
clipping, 327
coiling, 327
common sites of aneurysms, 316f
electrolyte disorders, 326–327
extubation, 331
giant aneurysms and circulatory 
arrest, 331
grading of SAH, 319–321, 320f
initial management concerns in 
neurocritical care unit, 
321–327
hydrocephalus, 322
ICG-VA, 330–331
intraoperative aneurysm rupture, 
330–331
neurogenic stunned myocardium, 326
NPE, 326
patient with subarachnoid hemorrhage, 328
postoperative management of 
patients, 332
prevalence and incidence, 316
natural history, course, complications, 
prognosis, 317
risk factors, 317
rebleeding, 321–322
seizures, 326
surgical position, 329
temporary clipping and brain protection 
strategy, 330
timing of surgery, 327
vasospasm, 322–325
ANF. See Atrial natriuretic factor (ANF)
Angiographic vasospasm. See Radiographic 
vasospasm
Angiography, 235–236
Angiomas, 699
Angioplasty, 325
Angiotensin-converting enzyme 
inhibitors (ACE inhibitors), 
421, 698, 700–701
Index1000
Animal models, 588, 893–894
Animal studies, 234
Ankylosing spondylitis (AS), 409, 413–414, 
571
ANP. See Atrial natriuretic peptide (ANP)
Antacid prophylaxis, 328
Anterior approaches, 432–434
Anterior atlas–dental interval (AADI), 401
Anterior cerebral artery (ACA), 
9–10, 135
Anterior cervical diskectomy (ACD), 401
Anterior communicating artery (ACom), 316
Anterior cord syndrome, 561
Anterior interbody fusion (ALIF), 463
Anterior ION (AION), 441
Anterior limb, 18b
Anterior longitudinal ligament 
(ALL), 401
Anterior lumbar interbody fusion (ALIF), 
403
Anterior median fissure, 48
Anterior region, 837
Anterior spinal artery (ASA), 87
syndrome, 88
Anterior thoracoabdominal approach, 434
Anti-Acetylcholiesterase antibodies 
(Anti-AChR antibodies), 
735–736
Anti-Acetylcholinesterase (AChesterase), 
738, 741
Antiapoptotic activity, 124
Antibiotics, 557, 576, 613, 947
antimicrobial prophylaxis in neurosurgery, 
620–623
antimicrobial therapy in neurosurgery, 
613–616
prophylaxis, 875
treatment of CNS infectionsin 
neurosurgical patient, 616–620
Antibody assays, 748
Anticholinergics, 290
Anticholinesterase, 290, 738
Anticoagulants, 346
therapy, 696
Anticoagulation
immediate, 688–689
indefinite, 689
management, 349
medications, 696
therapy, 689
Anticonvulsant therapy, 675
Antidiabetic agents (ADAs), 718, 718t
Antidiuretic hormone (ADH), 326–327, 379, 
644, 823–824
Antiemetic(s), 242
for PONV, 921
prophylaxis, 245, 296
Antiepileptic drugs (AEDs), 222–223, 286, 
288, 290–291, 302–303, 688, 793
therapy, 313
withdrawal, 310
Antiepileptics (AE), 242, 793
medications, 294, 296
Antifibrinolytics, 322
Antiganglioside antibodies, 751
Antihypertensive drugs, 700–701, 725, 725t
Antiinflammatory, 54
considerations in inducing barbiturate 
coma, 55–56
effects of anesthetics in treatment of 
refractory SE, 55
Antimicrobial prophylaxis in neurosurgery, 
620t
administration and timing, 621, 621t
choice of agent, 620–621
dosing in patients with renal impairment, 
622
duration, 622
efficacy, 620
and MDR pathogens, 622–623
patients under antibiotic therapy, 622
in patients with basilar skull fractures 
and cerebrospinal fluid leakage, 622
redosing, 622
weight-based dosing, 621–622, 621t
Antimicrobial therapy in neurosurgery, 
613–616
blood–brain barrier, 614–615
emergence of multidrug-resistant 
pathogens, 616
pathogens causing neurosurgical CNS 
infections, 615–616, 616t–617t
risks associated with administration of 
antibiotics, 616
Antimicrobial treatment, 619
Antioxidant, 772
Antiplatelet
drugs, 349, 362
therapy management, 349
Antisepsis, 930
Antisialogogues, 191
Aortic insufficiency, 699
Aortic stenosis (AS), 694, 698
Aortocaval compression, 671–672
AP. See Area postrema (AP)
Apex, 22
Apnea–Hypopnea Index (AHI), 213
Apneic volume, 234
Apolipoprotein E (APOE), 559
Apoplexy. See Acute hematoma
Apoptosis, 125, 127
cascades, 541, 542f
cell death, 565
Aqueous substance, 51
Aqueous vasopressin, 824
Arachnoid, 836
Arachnoid villi, 81
granulations, 322
ARDS. See Adult respiratory distress 
syndrome (ARDS)
Area postrema (AP), 248
ARI. See Autoregulatory index (ARI)
ARISCAT risk index, 212
Arnold-Chiari malformation, 635–636, 636t
ARRB2. See Beta-arrestin 2 receptor 
(ARRB2)
Arterial blood gas (ABG), 421, 451
analysis, 212, 744
Arterial blood pressure (ABP), 162–163, 
263, 451
echo-guided arterial cannula insertion, 
163f
Arterial CO2, partial pressure of, 72, 73f
Arterial hypertension, pathophysiology of, 
722–723
Arterial oxygen, partial pressure effects of, 
72–73
Arterial pressure, 262
Arterial system, 30–32, 68, 69f
Willis circle, 31f
Arterial-capillary-venous hypertensive 
syndrome, 356
Arteries of Adamkiewicz, 38, 87–88
Arteriovenous (AV), 643
anesthetic management of endovascular 
embolization of AV fistula, 
513–514
malformations, 649
Arteriovenous malformation (AVM), 
222–223, 346, 352, 352f, 510, 630–631, 
669. See also Carotid endarterectomy 
(CEA); Dural arteriovenous fistula 
(DAVF); Intracerebral hemorrhage 
(ICH); Vein of galen aneurysmal 
malformations (VGAMs)
anesthetic considerations for AVM 
embolization, 356–357
complications, 357
anesthetic considerations for resection, 
355–356
anesthetic management of endovascular 
embolization, 513–514
cause and incidence, 352
cerebral hemodynamics, 354
grading of, 353, 353t
imaging, 354
management, 354–355
natural history, 353
pathophysiologic effects and clinical 
presentation, 353
pediatric, 357
postoperative management, 356
endovascular therapy for, 
356, 357f
pregnancy and, 358
preoperative evaluation of patients with, 
224–225
surgical resection, 355
Arteriovenous oxygen difference (AjvDO2), 
78, 152
Arteritic AION, 442
Artery of Heubner, 30
Arthroplasty, 403
Artifacts, 143
ARUBA trial. See A Randomized Trial of 
Unruptured Brain Arteriovenous 
malformations trial (ARUBA trial)
ARx index. See Auditory evoked potential 
index (ARx index)
Arylcyclohexylamine, 109f
AS. See Ankylosing spondylitis (AS); Aortic 
stenosis (AS)
ASA. See American Society of 
Anesthesiologists (ASA); Anterior 
spinal artery (ASA)
aSAH. See Aneurysmal SAH (aSAH)
Asanguineous fluids, 815
Ascending pathways, 84
Index 1001
Ascending tracts of spinal cord, 36–39
blood supply of spinal cord, 39f
function, 38
spinal cord arterial supply, 38f, 39t
pathway, 36, 38b
type, 36
veins around spinal cord surface, 39
Asleep-awake-asleep technique (AAA 
technique), 297–298, 298t, 484–485, 
493
Aspirin, 696
Association fibers, 18, 47
Astrocyte foot process, 86
ATACH trial, 349
Atelectasis, 747
Atlantoaxial instability (AAI), 409
Atlantoaxial subluxation, 256
Atracurium, 741
Atrial myxoma, 699
Atrial natriuretic factor (ANF), 824
Atrial natriuretic peptide (ANP), 82
Atrioventricular node (AV node), 330
Audiological methods of ICP, 172
Auditory area, 11
Auditory evoked potential index 
(ARx index), 152
Automated implantable cardiac defibrillators 
(AICDs), 525–526
Autonomic disturbances
management, 752
in neuromuscular diseases, 601
Autonomic dysfunction, 600–601, 655, 
749, 956
Autonomic function, 89
Autonomic nervous system, 49–50, 576
parasympathetic nervous system, 50
sympathetic nervous system, 49–50, 50f
Autonomy, 868
Autoregulation, 71–72, 251
flow metabolism coupling, 72
myogenic control, 71
neurogenic control, 71–72
range, 630
of spinal cord, 88
Autoregulatory index (ARI), 137
AV. See Arteriovenous (AV)
AV node. See Atrioventricular node 
(AV node)
AVM. See Arteriovenous malformation (AVM)
Awake craniotomy (AC), 219–220, 242–245, 
289–290, 295–299, 489–490
anesthetic management
of patient with epilepsy, 302–303
of patients undergoing, 491b
anesthetic regime, 297–299
complications, 245
conduct of, 243–244, 244f–245f
for epilepsy, 496–499
indications, 243
monitoring, 296
patient selection, 490
perioperative management, 295–296
positioning of patients, 296
postoperative care, 244
premedication, 296
preoperative assessment, 295
preoperative evaluation of patients for, 
219–220
techniques for, 243
for tumor surgery, 490–496
Awake technique, 243
Axial lumbar interbody fusion (Ax-LIF), 403
Axon, 48
Axonal injury, 540–542
cerebral edema, 543–544, 544t
cerebral glucose metabolism in TBI, 545
cerebral metabolic dysfunction, 544–545
CPP, 544
inflammation, 542
intracranial pressure, 544
physiologic response to brain injury, 
543–544
post–TBI energy crisis, 545
Azathioprine, 739
B
B waves, 66, 142
Back pain, 956
Baclofen, 761
Bacterial meningitis, 83
BAEP. See Brain stem auditory evoked 
potentials (BAEP)
BAERs. See Brain stem auditory evoked 
responses (BAERs)
Balloon angioplasty, 325, 332
Balloon occlusion test (BOT), 510
Barbiturates, 105–107, 289, 742, 886
current status, 107
effects, 105
cerebral effects, 105, 105t
physical properties of intravenous 
anesthetic agents, 105t
recent research, 107
Barbituric acid, 105, 105f
Basal ganglia, 16–17, 546
Basal insulin, 719
Basal plate, 48
Baseline assessed neurological, 250
Basilar skull fractures, 538
antimicrobial prophylaxis in patients 
with, 622
Basilar sulcus, 25
BBB. See Blood–brain barrier (BBB)
BD. See Becker muscular dystrophy (BD)
BDNF. See Brain-derived neurotrophic factor 
(BDNF)
Beat-to-beat control of blood pressure, 162
Becker muscular dystrophy (BD), 758
Benzodiazepines (BZDs), 55, 109–110, 109f, 
173, 290, 484, 498, 602, 664, 674, 917
current status, 110
effects, 110
cerebral effects, 105t, 110
premedication, 292
recent research, 110
Berlin questionnaire, 213
Berman intubating airway, 261
Beta-arrestin 2 receptor (ARRB2), 918
BGC. See Blood glucose concentration (BGC)
BHI. See Breath–holding index (BHI)
Bifrontotemporal, 805–806
Bilaminar germ disc, 42
Bilateral insonation, 859
Biochemical serum markers of TBI, 588–589
Bioenergetics failure, 775–776
Biomarkers in TBI, 587
biochemical serum markers, 588–589
discovery, 588
GFAP, 589
immunological/inflammatory cellular 
responses, 587
neuronal, 158
NSE, 590
pNF-H, 589
S100B protein, 589
Biometry, 976
Biopsy of lesions, 448
Biostatistics, 976
and applications, 976
data
analysis and presentation,989
categorical, 991
collection and preparation for analysis, 
987–988
continuous, 989–991
summarizing, 989
time to event data, 991–992
multivariable analysis, 994–995
relation between continuous variables, 
992–994, 994f
sample size in clinical trials, 985–987
statistical methods use in medical 
sciences, 976
study design, 982–985
BIS. See Bispectral index (BIS)
Bispectral domain, 150–151
Bispectral index (BIS), 150–151, 152f, 328, 
452, 491, 506, 663, 807
limitations, 151
monitoring, 151, 296
Bitemporal, 805–806
superior quadrantanopia, 395
Bladder dysfunction, 566
Bladder management, 576
Blanket neuroprotection, 97
Blastocele, 41–42
Blastocyst, 41–42
Blastomeres, 41–42
β-Blockers, 700–701, 705, 742
Blood, 340–341. See also Hemoglobin (Hb)
components, 648
glucose, 714
loss, 386, 647
management, 428–429, 428t
spill on surface, 932–933
supply
of internal capsule, 18b
of spinal cord, 86
transfusion, 647–648, 823b
Blood glucose concentration (BGC), 885
Blood Oxygen Level Dependent contrast 
(BOLD), 531–532
signals, 72
Blood pressure (BP), 65, 251, 322, 346, 420, 
509–510, 553–555, 597, 694–695
controls, 93, 893
fluctuations, 363
management, 349
Index1002
Blood sugar, 333
control
in emergency neurosurgical patient, 720
in intensive care setup, 720
management, 350
in perioperative period and neurocritical 
care, 718
Blood–brain barrier (BBB), 51, 105, 234, 248, 
542–543, 588, 613–615, 645, 662–663, 
684–685, 816–817, 884
cellular and molecular effects of 
anesthetics on, 52–54
clinical and experimental implications of 
anesthetics on, 54–56
permeability at, 51–52
Blood–CSF barrier, 79
Blood–spinal cord barrier, 564
BMI. See Body mass index (BMI)
Body fluid compartments, 643, 815, 816f
Body mass index (BMI), 211, 976
Body temperature, 340–341
Body weight (BW), 828
BOLD. See Blood Oxygen Level Dependent 
contrast (BOLD)
Bony skull, 838
BOT. See Balloon occlusion test (BOT)
Bowel dysfunction, 566
Boyle’s law, 271
BP. See Blood pressure (BP)
Bradyarrhythmias, 452
Bradycardia, 263, 302, 341, 577
Bradydysrhythmias, 575–576
Brain, 4, 62, 68, 74, 134, 152, 346, 536, 588. 
See also Central nervous system 
(CNS); Stroke
anatomy, 4–30, 5f
acoustic area, 11
association areas, 8b, 11
basal ganglia, 16–17
cerebellum, 29–30, 30f
cerebrum, 4–6
diencephalon, 11–15
frontal lobe, 5f, 6
functional areas of cerebral cortex, 
8–10, 9f
habenular nucleus, 15–16
internal capsule, 17, 17f
limbic system, 21f, 22–23
medulla, 26–29
medulla oblongata at different 
levels, 28
midbrain, 23–24
nucleus subthalamicus, 16
parietal lobe, 7–8, 7f
pons, 25
premotor area, 10
reticular formation, 29
sensory areas, 10–11
temporal lobes, 5f, 6
ventricular system, 19–22, 20f
visual area, 11
white matter, 18–19, 19f
zona incerta, 16
Brain Lab, 520, 523
bulge, 239–240, 240f
contusions, 546
dead donor management, 873–875, 875t
hormonal resuscitation regime, 875t
development, 46–48
CNS development, 46f
mesencephalon, 47
prosencephalon, 46–47
rhombencephalon, 47–48
stages, 124
embryological differentiation, 4
functional testing, 298
herniation, 248
syndromes, 64f, 64t
hyperglycemia and, 715–716
hypoglycemia and, 716
injury, 587–588
by physical mechanism, 537
physiologic response to, 543–544
metabolism, 74, 162–171
cerebral metabolism, 74–79
in presence of oxygen, 75
microvasculature, 51
monitoring, 901–902
protection in neurosurgery
anesthetic agents, 97–98
blood pressure control, 93
evidence for brain protective strategies, 
885
hemoglobin concentration, 95–96
induced arterial hypertension, 94
integration of injury mechanisms, 97f
mild hypothermia, 92–93
neuroprotection during neurosurgical 
procedures, 92t
non-anesthetic agents, 97, 98t
nonpharmacological strategies, 91
normoglycemia, 94–95, 95t
pharmacological strategies, 96, 96f
strategy, 330
surgical brain injury during neurosur-
gical procedures, 92t
relaxation, 295, 329
swelling, 356, 543, 646, 823
tissue, 239
blood, 630
oxygenation, 329
trauma foundation guidelines, 887, 888t
tumors, 217–218, 520, 637–638
clinical implications, 967
HRQoL in patients with, 967
treatment effect on HRQoL, 967
vascular supply of, 30–33
Brain death, 607, 856, 872–875
catastrophic brain injury, 856
certification of BSD, 861–863
criteria
for certifying BSD, 857–859
for diagnosing death, 856
need for brain death diagnosis, 856
pathophysiology after brain death, 872–873
pitfalls/controversies, 859–860
rules regulating diagnosis of brain death, 
856–857
Brain stem
centers, 302
dorsal view, 24f
dysfunction, 601
lateral view, 23f
surgery, 708
transverse section, 26f
ventral view, 25f
Brain stem auditory evoked potentials 
(BAEP), 145, 147–149, 329, 452, 633, 
859
factors affecting, 148
stimulus characteristics, 147–148
uses, 148–149
waveforms, 148, 148f, 148t
Brain stem auditory evoked responses 
(BAERs), 263
Brain stem death (BSD), 862f
ancillary tests, 858–859
clinical examination, 857–858
prerequisites, 857
Brain tissue oxygen (PbtO2), 595
monitoring, 156–158
complications, 158
limitations, 157
O2 reactivity index, 157, 157t
probe placement, 157
technology, 156–157
uses, 157
values, 157
tension, 551, 605, 797–798
Brain Trauma Foundation (BTF), 549, 
599, 885
Brain-derived neurotrophic factor 
(BDNF), 910
Breastfeeding, 809
Breathe, 237
Breath–holding index (BHI), 170
British aneurysm nimodipine trial, 324
Broca, 10
Brodmann areas, 8b
in neocortex, 10f
Brown–Séquard syndrome, 561
BSD. See Brain stem death (BSD)
BSR. See Burst suppression ratio (BSR)
BTF. See Brain Trauma Foundation (BTF)
Buccopharyngeal membrane, 44
Bulbar muscle, 737
Bulbar weakness, 745
Bundle approach for reducing infection, 
942–943
Buprenorphine, 920
Burst suppression ratio (BSR), 328
N-Butyl cyanoacrylate (NBCA), 356, 514
BW. See Body weight (BW)
BZDs. See Benzodiazepines (BZDs)
C
C waves, 66, 142
C9H8N2. See Benzodiazepine
CA-UTI. See Catheter-associated urinary 
tract infection (CA-UTI)
Cabergoline, 380–381
CAD. See Coronary artery disease (CAD)
Calcitonin gene-related peptide (CGRP), 
71–72
Calcium channel blockers (CCB), 324
Calcium sensitization, 71
Calcium-independent mediated theory, 71
Calpain, 565
Index 1003
CAM. See Confusion Assessment Method 
(CAM)
Canet risk index. See ARISCAT risk index
Capnography, 244, 268
Carbamazepine, 761
Carbon dioxide (CO2), 104, 170, 194, 290
partial pressure effects of arterial, 72–73
reactivity of spinal cord, 88
Carbonic anhydrase inhibitors, 82
Carcinoid tumors, 292
Cardiac arrest, 703. See also Circulatory 
arrest
incidence of, 704t
in neurosurgical patients, 706–709, 707t
during aneurysm repair procedures, 708
in posterior fossa surgery, 707–708
spine surgery, 709
in supratentorial cases, 706–707
in surgery of base of skull, 707
Cardiac complication, 351
with adenosine use, 371
care of joints and limbs, 577
gastrointestinal tract dysfunction, 576
initial bladder management, 576
and management, 575–576
prophylaxis against thromboembolism, 
576
skin and pressure areas, 576–577
temperature, 576
trauma reevaluation, 577
use of antibiotics, 576
use of steroids, 576
Cardiac disease, 693
Cardiac dysfunction, 281–282, 302, 600–601
Cardiac evaluation, 421
Cardiac failure, 281, 358
Cardiac fibrillation, 341
Cardiac implantable electronic devices 
(CIEDs), 526–529, 529f
Cardiac index (CI), 191
Cardiac injury, 326
Cardiac output (CO), 163–164, 189, 326
Cardiac rhabodomyomas, 291–292
Cardiac rhythm disturbances, 342
Cardiac risk preoperative evaluation in 
neurosurgical patients, 210–211
assessment of functional capacity, 211
indication for cardiac testing during 
preoperative evaluation, 211
risk assessment tools for estimating 
cardiac risk, 210–211
Cardiac surgery, 137
Cardiac troponin I (cTI), 326
Cardiomyopathy, intraoperative cardiac 
function in patients with, 281–282
Cardiopulmonary bypass (CPB), 339–341, 
368, 369f
management of closed chest, 369–370
Cardiopulmonary resuscitation (CPR), 280, 
703, 959
in neurosurgical patients, 706–709
under anesthesia, 708
factors in neurosurgical patients, 707t
in lateral position,709
in patient with open wound, 709
in prone position, 708
in sitting position, 709
spine surgery, 709
quality, 706
Cardiopulmonary system, 872
Cardiovascular care, 599–601
autonomic disturbances in neuromuscular 
diseases, 601
autonomic dysfunction initiated by 
neurological injury, 600–601
hemodynamic manipulations in 
vaso-occlusive conditions, 599–600
optimization of CPP, 599
Cardiovascular effects, 565
Cardiovascular system (CVS), 262, 450–451, 
655, 671–672, 757
Care
cleaning and reprocessing of patient care 
equipment, 933–935
of dying patient, 960
general ICU care, 350
meticulous care, 241
physical, 960
psychological, 960
social, 960
spiritual, 961
supportive care, 752
Carotid artery disease, 362
Carotid artery stenting (CAS), 360, 514
Carotid disease, 256
Carotid endarterectomy (CEA), 136–137, 145, 
360–361, 514. See also Arteriovenous 
malformation (AVM); Dural arterio-
venous fistula (DAVF); Intracerebral 
hemorrhage (ICH); Vein of galen 
aneurysmal malformations (VGAMs)
intraoperative management, 363
management of carotid artery disease, 362
monitoring, 362–363
postoperative complications and 
outcomes, 363
preoperative evaluation, 362
Carotid puncture, 139
Carotid stenosis, 361t
Carotid-cavernous fistula (CCF), 513
CAS. See Carotid artery stenting (CAS); 
Coronary angioplasty and stenting 
(CAS)
Case report, 982
Case series, 982
Case-by-case basis, 490
Case-control studies, 983
sample size in, 987, 988t
Caspases, 565
CAT. See Computerized axial tomography 
(CAT)
Catastrophic brain injury, 856
Catechol-O-Methyltransferase (COMT), 918
COMT V128M, 914
Catecholamine
blood levels, 248
effect, 874
efficacy, 873
Categorical data, 991
Categorical variables, 977, 989
Catheter-associated urinary tract infection 
(CA-UTI), 940
Catheter-related blood stream infection 
(CR-BSI), 940, 942
Catheterizing, 237
Cauda equine, 49
CBF. See Cerebral blood flow (CBF)
CBV. See Cerebral blood volume (CBV)
CCB. See Calcium channel blockers (CCB)
CCF. See Carotid-cavernous fistula (CCF)
CCO. See Continuous cardiac output (CCO)
CDC. See Centers for Disease Control and 
Prevention (CDC)
CEA. See Carotid endarterectomy (CEA)
cEEG monitoring. See Continuous EEG 
monitoring (cEEG monitoring)
Cefazolin, 621
Cefepime, 616, 619
Ceftazidime, 619
Celecoxib, 842
Celiac ganglia, 49–50
Cell death cascades, 540–541
Cellular
effects of anesthetics, 52–54
migration, 124
mitosis, 673
organelles, 74
Centers for Disease Control and Prevention 
(CDC), 931, 945
Central cord
infarct, 88
syndrome, 561
Central diabetes insipidus, 824
Central nervous system (CNS), 4, 104, 123, 
248, 285–286, 479, 565, 588, 600, 613, 
618t, 629, 656, 744, 757, 783. See also 
Peripheral nervous system (PNS); 
Stroke
changes, 673
infections in neurosurgical patient, 
616–617, 618t
antimicrobial treatment, 619
diagnosis, 619
management of device-associated CNS 
infections, 619–620
microorganisms, 617–619
infections treatment in neurosurgical 
patient, 616–620
neurosurgical CNS infections, 615–616
vasculature, 883
Central pontine myelinosis, 818–819
Central retinal artery occlusion (CRAO), 
201–202, 441–442
Central sulcus, 4
Central venous
access, 329
catheter, 263
Central venous pressure (CVP), 65, 187–188, 
262, 323, 427, 451–452, 823
Cerebellar hemangioblastomas, 256
Cerebellar hemispheric lesions, 632
Cerebellopontine angle tumors 
(CPA tumors), 258
Cerebellum, 29–30, 30f, 48
Cerebral angiogram, 363, 519–520
Cerebral angiography, 235–236, 318
Cerebral angioplasty, 325
Cerebral autoregulation, 70–71, 247, 817
Index1004
Cerebral autoregulatory response, 364
Cerebral AVM, 224
Cerebral blood flow (CBF), 68, 74, 93, 104, 
123, 238, 247, 262, 311, 340, 349, 
531–532, 536, 543, 597, 629–630, 646, 
798, 817, 883
autoregulation, 543
brain, 68
factors affecting, 72–73
measurement, 73–74
monitoring, 134–139, 604–606
regulation, 70–71
studies, 323
vascular anatomy, 68–74
Cerebral blood volume (CBV), 104, 139, 543
Cerebral circulation, 721–722
Cerebral compliance, 62–63
pressure–volume relationship of ICP, 63f
stages of increase in ICP, 63t
Cerebral contusions, 538, 538f
Cerebral cortex, 4
association areas, 8b, 11
functional areas, 8–10, 9f
Cerebral dehydration, 818–819
Cerebral edema, 543–544, 544t, 547
Cerebral energy state, 544–545
Cerebral glucose metabolism, 545, 715
Cerebral hemodynamics in AVM, 354
Cerebral hyperemia, 251
Cerebral hyperperfusion, 251–252
Cerebral hypoglycemia, 716
Cerebral hypoxia, 157
Cerebral ischemia, 52–53
Cerebral metabolic coupling, 76–77
astrocyte–neuron lactate shuttle, 77f
neuron-glial coupling, 76f
Cerebral metabolic demand for oxygen 
(CMRO2), 78
Cerebral metabolic dysfunction, 544–545
Cerebral metabolic rate (CMR), 104
Cerebral metabolic rate for oxygen 
consumption (CMRO2), 105, 152, 238, 
629–630
Cerebral metabolic uncoupling, 77
Cerebral metabolism, 74–79, 531–532
brain energy, 74–75
brain metabolism in presence of oxygen, 
75, 75f
control, 76–79
in hypoglycaemic states, 75–76
in hypoxic state, 75
Cerebral microdialysis (CMD), 78–79, 
157–159, 323, 605–606, 724, 902
limitations, 158–159
PET, 79
probe placement, 158
uses, 158
Cerebral oxygenation monitoring, 152, 329
Cerebral peduncle, 23–24
Cerebral perfusion pressure (CPP), 63, 93, 
107, 135, 161, 187, 239, 249, 259–260, 
360, 450, 473–474, 543–544, 556, 599, 
604, 656, 721, 796, 817, 823, 883
Cerebral protection, 145, 355
Cerebral resuscitation, 237
Cerebral salt wasting syndrome, 822, 824
Cerebral swelling, 543
Cerebral tissue, 352
Cerebral transluminal angioplasty, 657
Cerebral tumor, 496–497
Cerebral vascular resistance (CVR), 71
Cerebral vasoconstriction, 555
Cerebral vasospasm, 543, 599, 657, 679
Cerebral venous hypertension, 360
Cerebral venous pressure, 241
Cerebral venous system, 32–33
Cerebral venous thrombosis (CVT), 681
age and sex distribution, 682f
anesthetic management, 689–690
clinical manifestations, 685–686
conditions with, 683t–684t
diagnostic evaluation, 687–688
incidence of, 681–683
pathophysiology, 684–685, 685f
prognosis, 690
radiologic findings in patients with, 687f
risk factors, 683–684
signs and symptoms based on location of, 
686t
treatment, 688–689
venous anatomy, 681
venous outflow vessels of brain, 682f
Cerebral visual loss. See Cortical blindness
Cerebrospinal fluid (CSF), 19, 33–39, 46, 
52–53, 62, 79, 141, 187, 248, 256, 272, 
318, 369, 400, 519–520, 538, 588, 
602–603, 614, 614t–615t, 630, 646, 673, 
684–685, 790, 838, 945
antimicrobial prophylaxis in patients with 
CSF leakage, 622
diversion, 472
drainage, 349–350
dura mater, 33–34
dynamics, 83, 104
pathologies effects, 82–83
imaging of CSF pathways, 83
infection, 449
leakage, 387
spinal cord, 34–39
ventricular system, 79–83
Cerebrovascular accident (CVA), 654, 657, 
717
Cerebrovascular CO2 reactivity, 138
Cerebrovascular disease, 669
AVM, 346, 352, 352f
CAS, 363
CEA, 360–361
DAVFs, 360
ICH, 346
MMD, 363
VGAMs, 358–360, 358f–359f
Cerebrovascular pressure reactivity, 67–68, 
67f
Cerebrovascular resistance (CVR), 135
Cerebrovascular surgery. See also Spinal 
surgery
adenosine-assisted cerebral blood flow 
arrest, 370–372
DHCA, 367–370
RVP–assisted cerebral blood flow arrest, 
372–373
Cerebrum, 4–6
Cervical spine
airway considerations in patients with 
cervical spine disorders, 425
congenital abnormalities involving, 
411–412
degenerative disease of, 405–407, 406f
immobilization, 570
interpretation of cervical spine 
radiograph, 571, 571f
mobility evaluation, 422–423
surgeries, 432–434
Cervical spine limitation (CSL), 411, 411t
Cervical spondylotic myelopathy (CSM), 405
Cervical spondylotic radiculopathy (CSR), 
405
Cervicis, 838
Cesarean delivery, 678
CFS, 34–35
CGRP. See Calcitonin gene-related peptide 
(CGRP)
Charlson Comorbidity Index, 664
Chemical sterilant, 930
Chemokines, 587
CHEST trial. See Crystalloid versus 
Hydroxyethyl Starch Trial 
(CHEST trial)
Chest X-ray, 212, 326
Cheyne–Stokes respiration, 66
CHF. See Congestive heart failure (CHF)
Child position, 631–632, 632f
2-Chloro-2-(difluoromethoxy)-1,1,1-trifluoro-ethane, 113–114, 113f
Choreiform movements, 764–765
Choriocarcinoma, 670
Choroid fissure, 20, 46–47
Choroid plexus, 46–48, 79, 80f
Choroidal secretion, 79
Chromophores, 154
Chronic demyelinating polyradiculoneu-
ropathy (CIDP), 750
Chronic headache, 843
Chronic hypertension, 722
Chronic obstructive pulmonary disease 
(COPD), 210, 775
Chronic pain following craniotomy, 843
Chronic phase, 565
Chronic vagal nerve stimulation, 302
CI. See Cardiac index (CI); Confidence 
interval (CI)
CIDP. See Chronic demyelinating polyra-
diculoneuropathy (CIDP)
CIEDs. See Cardiac implantable electronic 
devices (CIEDs)
CIM. See Critical illness myopathy (CIM)
CIP. See Critical illness neuropathy (CIP)
Circadian rhythms, 15
Circle of Willis (CW), 68, 69f, 94
Circulation, 237
Circulatory arrest, 331, 339. See also Cardiac 
arrest
adenosine-induced, 341, 341t
anesthesia considerations, 342
anesthesia management, 340–341
complications, 341–342
DHCA, 339–340
Cisatracurium, 741
Index 1005
Citrate, phosphate, dextrose (glucose), and 
adenine (CPDA), 648
CJD. See Creutzfeldt-Jakob disease (CJD)
Clark electrode, 156–157
Claustrophobia, 525
Claustrum, 8
Clazosentan, 324–325
Cleaning, 930, 937
and disinfection of medical instruments, 
933
in health care facilities, 931
of OR, 941
principal goal of, 930–931
and reprocessing of patient care 
equipment, 933–935
Cleavage, 41–42
Clinical cord syndromes, 561
Clinical vasospasm. See Delayed ischemic 
neurological deficit (DIND)
Clipping, 327
Clonidine, 296, 700–701
CMAP. See Compound action potential 
(CMAP)
CMD. See Cerebral microdialysis (CMD)
CMR. See Cerebral metabolic rate (CMR)
CN. See Cranial nerve (CN)
CN IX–XII. See Lower cranial nerves 
(CN IX–XII)
CNS. See Central nervous system (CNS)
CO. See Cardiac output (CO)
Coadjuvant opioids, 807
Coagulase-negative staphylococci, 619
Coagulation abnormalities, 265
Coagulopathy, 341
Coaxial catheter, 332
Cochrane metaanalysis, 752
Cochrane systemic review, 113
Codeine, 919
Codeine phosphate, 840
Cognition, 955–956
decline, 658
dysfunction, 126
functions, 249
impairment, 249
Cohort study, 984
Coil embolization, 332
Coiling, 327
Collaborative multicenter clinical research, 
894
Colloid crystalloid controversy, 821
Colloid(s), 820–821
crystalloid/colloid comparison, 821t
fluids, 829–831
osmotic pressure, 818
Colonization, 947
Color flow Doppler, 169
Coma, 310–313, 317
Commissural fibers, 19, 47
Compound action potential (CMAP), 419
Compressed spectral array (CSA), 144
Computed tomographic angiography (CTA), 
318–319, 346
Computed tomography (CT), 220, 270, 417, 
447–448, 480, 505, 545, 546f, 587, 
639–640, 640f, 674–675, 687, 738, 
791–792, 859
anesthesia for, 506
CT-based techniques, 73–74
perfusion, 139, 323
scan, 83, 237
Computerized axial tomography (CAT), 
519–520
COMT. See Catechol-O-Methyltransferase 
(COMT)
Concorde position, 191–192, 192f
Concussion, 538
Confidence interval (CI), 210–211, 472, 898
Confusion Assessment Method (CAM), 664
CAM-ICU, 664
Congenita, myotonia, 755
Congenital abnormalities involving cervical 
spine, 411–412
Congenital heart disease, 700
Congestive heart failure (CHF), 638
Conscious sedation, 332, 485, 492–493
CONSCIOUS-1 trial, 324–325
CONSCIOUS-2 trial, 324–325
CONSCIOUS-3 trial, 324–325
Consent form, 863
Constant, 977
Continuous cardiac output (CCO), 451–452
Continuous data, 989–991
Continuous ECoG, 294
recordings, 287–288
Continuous EEG monitoring (cEEG 
monitoring), 311
Continuous entrainment, 264–265
Continuous intraoperative facial nerve, 263
Continuous positive airway pressure 
therapy (CPAP therapy), 213, 426–427
Continuous propofol infusion, 289–290
Continuous variables, 977, 989
relation between, 992–994
Contraindications, 776–777
Contrast–related hazards, 525
Control group, 984
Conus medullaris, 34
COPD. See Chronic obstructive pulmonary 
disease (COPD)
Cord ischemia, 88
Corona radiate, 8
Coronal section
anterior view of left hemisphere, 9f
through brain, 7f
corpus callosum on, 8
Coronary angioplasty and stenting (CAS), 363
Coronary artery disease (CAD), 256, 329, 
342, 421, 693
Corpus callosum, 19, 47
Corpus striatum, 47
Correlation coefficient (R) between AMP 
amplitude (A) and mean pressure (P) 
(RAP), 66–67
Cortex, 8–9
Cortical blindness, 202, 441–443
Cortical disruption, 540
Cortical mapping, 287–288, 300, 490, 493
Cortical spreading depolarizations (CSDs), 
114, 540
Cortical spreading depression, 322
Corticoid Randomisation After Significant 
Head injury (CRASH), 559
Corticosteroids, 739, 742, 752, 761, 845, 885
Coughing, 241
Counterpressure, 708
Coup injuries, 537
Covariate variable. See Exposure variable
Covariates, 994–995
COX-2. See Cyclooxygenase 2 (COX-2)
CPA tumors. See Cerebellopontine angle 
tumors (CPA tumors)
CPAP therapy. See Continuous positive 
airway pressure therapy (CPAP 
therapy)
CPB. See Cardiopulmonary bypass (CPB)
CPDA. See Citrate, phosphate, dextrose 
(glucose), and adenine (CPDA)
CPP. See Cerebral perfusion pressure (CPP)
CPR. See Cardiopulmonary resuscitation 
(CPR)
CR-BSI. See Catheter-related blood stream 
infection (CR-BSI)
Cranial nerve (CN), 25, 50
dysfunction, 387, 789
palsies, 363
Craniectomies, 271
Craniopharyngioma, 647
Craniosynostosis, 636–637, 649
Craniotomy, 340–341, 836
alignment of head and neck, 187
anatomical and physiological basis of pain 
following, 836–838
chronic pain following craniotomy, 843
closure, 240
head positioning, 187
patient positioning for spinal procedures, 
195–202
positions
concorde position, 191–192, 192f
dorsal decubitus position, 189–190, 189f
lateral position, 190, 190f
park bench position, 190, 190f
prone position, 191, 192f
semilateral position, 191
sitting position, 193–195
supine position, 189–190, 189f
three-quarters prone, 192
transnasal transsphenoidal surgery, 
approach for, 192–193
transoral approach, 192
site, 838
surgical approach for, 186, 186t
Craniovertebral junction (CVJ), 400
anomalies, 409, 409t, 410f
Cranium, pain-sensitive structures of, 838
CRAO. See Central retinal artery occlusion 
(CRAO)
CRASH. See Corticoid Randomisation 
After Significant Head injury 
(CRASH)
Creutzfeldt-Jakob disease (CJD), 902, 
930–931
CJD inactivation, precaution for, 939
Critical illness myopathy (CIM), 771–772
Critical illness neuropathy (CIP), 771–772
Critical items reprocessing, 935
Cross-sectional studies, 982–983
sample size in, 987, 987t
Index1006
Cross-transmission of pathogens, 946
Cryoprecipitate, 429, 648
Cryotherapy, 843
Crystalloid, 827
fluids, 827–831
solutions, 646
Crystalloid versus Hydroxyethyl Starch Trial 
(CHEST trial), 885
CSA. See Compressed spectral array (CSA)
CSDs. See Cortical spreading depolarizations 
(CSDs)
CSF. See Cerebrospinal fluid (CSF)
CSL. See Cervical spine limitation (CSL)
CSM. See Cervical spondylotic myelopathy 
(CSM)
CSR. See Cervical spondylotic radiculopathy 
(CSR)
CT. See Computed tomography (CT)
CTA. See Computed tomographic 
angiography (CTA)
cTI. See Cardiac troponin I (cTI)
Curative surgical procedures, 286–287
Curative surgical resection, 286
Curcumin, 105
Cushing disease, 383
preoperative steroid management, 383
CVA. See Cerebrovascular accident (CVA)
CVJ. See Craniovertebral junction (CVJ)
CVP. See Central venous pressure (CVP)
CVR. See Cerebral vascular resistance (CVR); 
Cerebrovascular resistance (CVR)
CVS. See Cardiovascular system (CVS)
CVT. See Cerebral venous thrombosis (CVT)
CW. See Circle of Willis (CW)
Cyclooxygenase 2 (COX-2), 842
Cyclophosphamide, 740
Cyclosporine, 740
CYP enzymes. See Cytochrome P450 
enzymes (CYP enzymes)
CYP2D6, 914–915, 919
Cyst fenestration, 458–459
Cytochrome P450 enzymes (CYP enzymes), 
914
anesthesia-related substrates, 915t
cytochrome P450 isoenzymes, 290
Cytokine, 542
dysregulation, 662–663
Cytotoxic edema, 543–544
D
DAI. See Diffuse axonal injury (DAI)
Dantrolene, 761
DAP. See 3,4-Diaminopyridine (DAP)
Data
analysis, 989
categorical, 991
collection and preparation for analysis, 
987–988
continuous, 989–991
summarizing, 989
time to event, 991–992
validation,987–988
DAVF. See Dural arteriovenous fistula 
(DAVF)
Davson’s equation, 62
DBP. See Diastolic blood pressure (DBP)
dBpeSPL. See Decibel peak equivalent sound 
pressure level (dBpeSPL)
DBS. See Deep brain stimulation (DBS)
DC. See Decompressive craniectomy (DC)
DCI. See Delayed cerebral ischemia (DCI)
DD. See Delta-down (DD)
DDAVP. See Desmopressin acetate (DDAVP)
Death, 856
Death cascades, 541
apoptosis cascades, 541, 542f
necrosis, 541
“Death rattle”, 960
Decibel peak equivalent sound pressure 
level (dBpeSPL), 147
Decision making for incompetent patients, 
864–865
Decompensated heart failure, 694
Decompression of spinal cord, 577–578
airway management, 577
anesthetic concerns in acute SCI, 
577–578
intraoperative concerns, 577–578
postoperative concerns, 578
Decompressive craniectomy (DC), 552–553, 
884–885
Decompressive Craniectomy in Diffuse 
Traumatic Brain Injury (DECRA), 
884–885
Decontamination, 930
Deep brain stimulation (DBS), 448, 479–480, 
763, 898
disease conditions and therapeutic areas 
for, 480t
minimally invasive, 464–466, 465f
Deep brain stimulators, 526
devices, 619–620
in situ, anesthesia in patients with, 486
Deep cerebral veins, 32–33
Deep hypothermia, 92–93
Deep hypothermic circulatory arrest 
(DHCA), 331, 339–341, 367, 605. 
See also Cardiac arrest; Circulatory 
arrest
anesthesia management, 368–370
case selection and indications, 
367–368
complications and associated 
postoperative outcomes, 368
in neuroanesthesia, 367
Deep vein thrombosis (DVT), 351, 422, 
671–672
prophylaxis, 679, 752
Deep venous system, 69–70
Deep venous thrombosis, 557
Defensive medicine, 865
Defibrillation, 708–709
Definitive notochord, 44, 44f
Dehydration, 644, 700, 719
Delayed calcium influx, 564
Delayed cerebral ischemia (DCI), 319–321
Delayed emergence, 250–251, 271
agitation during emergence from 
anesthesia, 250
and arousal, 250–251
causes of, 251
planned, 250–251
Delayed ischemic neurological deficit 
(DIND), 322
Delirium, 127, 653, 655, 662, 900
Delivery, timing and method of, 675
Delta pulse pressure (DPP), 164
Delta-down (DD), 164, 165f
Dementia, 127
Demyelinating disease
GBS, 788–789
MS, 789–791
Density spectral array (DSA), 144
Deoxyhemoglobin, 531–532
Dependent variable, 994–995
Depolarizing neuromuscular blocking 
agents, 115
Depth electrodes, 294
Depth of anesthesia, 150–152, 173–174, 184
electrocorticography, 173
evoked potentials for monitoring nervous 
system integrity, 173
hypnotic component of anesthesia 
monitoring, 173–174
miscellaneous, 174–175
nociception monitoring, 174
DES. See Direct electrocortical stimulation 
(DES)
Descending pathways, 84
Descriptive statistical methods, 979
Desflurane, 111–113, 112f, 124, 249
effects, 112
cerebral effects, 105t, 112
physical properties of inhalational 
anesthetic agents, 112t
research, 113
status, 112
Desmopressin, 388
Desmopressin acetate (DDAVP), 
388, 824
Destabilization phase, 405
Device-associated CNS infections 
management, 619–620
Dexamethasone, 242
Dexmedetomidine, 111, 126, 249–250, 290, 
297–299, 332, 493, 497, 705, 842, 
886–887, 918
infusion, 293
recent research, 111
Dextran, 823, 830
Dextromethorphan, 842
Dextrose, 821
dextrose-containing fluids, 719
dextrose-containing solutions, 644
DHCA. See Deep hypothermic circulatory 
arrest (DHCA)
DI. See Diabetes insipidus (DI)
Diabetes, 456, 658, 714
anesthetic management, 719
blood sugar control
in emergency neurosurgical patient, 720
in intensive care setup, 720
blood sugar management, 718
cerebral glucose metabolism, 715
cerebrovascular accidents, 717
diabetic dysautonomia, 716
glycemic control in neurosurgical subsets, 
717
Index 1007
glycemic indices, 714
hyperglycemia and brain, 715–716
hyperglycemic neuropathy, 716
hypoglycemia and brain, 716
incidence of, 714
intraoperative management, 719
modes of glucose measurement, 714
nutrition, 720
pathophysiology of, 715
patients with, 213, 214t
postoperative glycemic management, 719
SAH, 717
spine surgery, 718
TBI, 717
tumor surgery, 718
Diabetes insipidus (DI), 384, 387–389, 452, 
476, 637, 647, 824
fluid management in, 388
hyponatremia, 388–389
Diabetes mellitus. See Diabetes
Diabetic dysautonomia, 716
Diabetic ketoacidosis (DKA), 718
Diabetics, 718
Diagnostic and Statistical Manual of Mental 
Disorders (DSM), 661–662
Diagnostic angiography, anesthesia for, 510
Diagnostic neuroradiology, 505
3,4-Diaminopyridine (DAP), 748
Diaphragm sella, 34
Diastolic blood pressure (DBP), 600, 671
Diastolic velocity (Vd), 171
Diazepam, 125–126, 761
Diencephalon, 11–15
epithalamus, 15
hypothalamus, 13–15
thalamus, 11–13, 12f
Diencephalon, 46–47
Differential diagnosis
GBS, 750, 750t
MC, 744–745
of acute respiratory failure, 744t
Differential spectroscopy, 154
Diffuse axonal injury (DAI), 538, 547, 547f
Diffuse injury, 537–538
Diffusion-weighted imaging (DWI), 318
Digital subtraction angiography (DSA), 318, 
323, 354, 640, 859
Dihydropyridines, 324
2,6-Diisopropylphenol, 107, 107f
DIND. See Delayed ischemic neurological 
deficit (DIND)
Dinitrogen monoxide, 114, 114f
Diplopia, 736–737
Direct electrocortical stimulation (DES), 298
Direct injury, 546
Direct laryngoscopy (DL), 409–411
Discrete variable, 977
Disease-specific measures, 965
Disinfection, 930, 937. See also Infections
blood spill on surface, 932–933
classification of medical devices and/or 
equipment, 930–931
cleaning
and decontamination of environmental 
surfaces, 931–932
medical instruments, 933
and reprocessing of patient care 
equipment, 933–935
HAI, 940
of HBV, 938–939
of HCV, 938–939
of HIV, 938–939
infections in operating rooms and 
intensive care units, 940–943
methods
for medical devices, 931
with examples, 933t
precaution for inactivation of CJD, 939
reprocessing
of endoscopes, 935–938
of respiratory apparatus, 935–936
Spaulding’s classification of devices, 931t
of tuberculosis-contaminated devices, 
938–939
Dissociated anesthesia, 108–109
Distribution-free methods, 982
Diuretics, 239
therapy, 815
DKA. See Diabetic ketoacidosis (DKA)
DL. See Direct laryngoscopy (DL)
DLT. See Double lumen tube (DLT)
DM. See Dystrophia myotonia (DM)
DMD. See Duchenne muscular dystrophy 
(DMD)
Do-not-resuscitate orders (DNR orders), 
606–607, 865, 959
Domperidone, 763
Donation after death, 872–876
management of donation after declaration
by circulatory criteria, 875–876
by neurological criteria, 872–875
Dopamine, 82
Doppler principle, 134–135, 134f
Dorsal decubitus position, craniotomy, 
189–190, 189f
Dorsal part of pons, 25
Dorsal root, 49
Dorsal root ganglion (DRG), 45–46, 49
Dosing in patients with renal impairment, 
622
Double lumen tube (DLT), 425
Dough nut–shaped foam, 197
Down syndrome, 411
Doxacurium, 741
DPP. See Delta pulse pressure (DPP)
DRE. See Drug resistant epilepsy (DRE)
DRG. See Dorsal root ganglion (DRG)
Dropped head syndrome, 736
dRoR. See Dynamic rate of autoregulation 
(dRoR)
DRS-R-98, 665
Drug metabolism of opioids, 919–920
buprenorphine, 920
codeine, 919
fentanyl, 920
hydrocodone, 919
methadone, 920
morphine, 919
oxycodone, 919
tramadol, 919
Drug resistant epilepsy (DRE), 286
Dry organic materials, 933
DSA. See Density spectral array 
(DSA); Digital subtraction 
angiography (DSA)
DSM. See Diagnostic and Statistical Manual 
of Mental Disorders (DSM)
Duchenne muscular dystrophy (DMD), 758
Dura mater, 33–34, 836–838
Dural arteriovenous fistula (DAVF), 360. 
See also Arteriovenous malformation 
(AVM); Carotid endarterectomy 
(CEA); Intracerebral hemorrhage 
(ICH); Vein of galen aneurysmal 
malformations (VGAMs)
clinical presentation, 360
management, 360, 361f
Dural sinuses, 264
Durant’s maneuver. See Left lateral 
decubitus position
DVT. See Deep vein thrombosis (DVT)
DWI. See Diffusion-weighted imaging (DWI)
Dynamic autoregulation, 71, 137
Dynamic cord compression, 405–407
Dynamic rate of autoregulation (dRoR), 137
Dynamic stabilization, 403
Dynamometry, 775
Dyselectrolytemias, 823, 824t
Dysphagia, 433
Dystrophia myotonia (DM), 756–758
Dystrophin, 758
E
EAAs. See Excitatory aminoacids (EAAs)
EACA. See Epsilon aminocaproic acid (EACA)
Early awakening, 240
Early neurological assessments, 250
Early surgical intervention, 351
Early tracheostomy, 352
EBM. See Evidence-based medicine (EBM)
EBP. See Evidence-based practice (EBP)
ECF. See Extracellular fluid (ECF)
ECG. See Electrocardiography (ECG)
Echocardiogram, 655
Echocardiography, 211, 281
Echography, 169
Eclampsia, 137
ECochG. See Electrocochleography (ECochG)
ECoG. See Electrocorticography (ECoG)
ECS. See Electrocerebral silence (ECS)
ECT. See Electroconvulsive therapy (ECT)
Ectoderm, 43–44
EDA. See End diastolic area (EDA)
Edema of face, 201
EDH. See Epidural hemorrhages (EDH)
Edinger–Westphal nucleus, 47
Edrophonium chloride test, 738
Edrophonium test, 738, 745
Education, 530
EDV. See End diastolic volume (EDV)
EEG. See Electroencephalography (EEG)
Efferent fibers, 16
8th Joint National Committee (JNC 8), 721
Elderly
implications of surgical stress and 
anesthesia on, 653
neurosurgical concerns unique to elderly, 
654–658
Index1008
Electrical potentials (EP), 419–420
Electrical stimulation, 772
Electrocardiogram. See Electrocardiography 
(ECG)
Electrocardiography (ECG), 211, 237, 263, 
280–281, 326, 417, 455–456, 525, 600, 
630, 655, 754
abnormalities, 383
monitoring, 695
recording, 509–510
Electrocerebral silence (ECS), 858
Electrocochleography (ECochG), 263
Electroconvulsive therapy (ECT), 805–806
anesthesia for, 806–809, 807t
conditions, 809
contraindications, 806
neuromuscular blocking agents for, 808t
preprocedure management, 806
side effects, 809
Electroconvulsive therapy, 289
Electrocorticogram, 145
Electrocorticography (ECoG), 173, 299, 494
anesthetic drugs effects on ECoG 
monitoring, 497–498
anticholinergics and anticholinesterases, 
498
inhalational agents, 498
intravenous agents, 498
local anesthetics, 498
neuromuscular blocking agents, 498
opioids, 498
Electrodiagnostic testing, 750
Electroencephalography (EEG), 105, 136, 
143–145, 143f, 173, 287, 310, 340, 362, 
368, 475, 496, 543, 552, 595, 805–806, 
856, 858
activity, 322–323
analysis, 144
burst suppression, 313
β-EEG activity, 300
EEG-based monitors, 263
EEG-identified epileptiform activity, 288
electrocorticogram, 145
electrocorticography, 173
evoked potentials for monitoring nervous 
system integrity, 173
hypnotic component of anesthesia 
monitoring, 173–174
inaccessible forehead for EEG monitoring, 
176
miscellaneous, 174–175
nociception monitoring, 174
normal EEG, 144, 144t
recording, 143
usage, 145
Electrolysis, 332
Electrolyte, 697, 817, 819–820, 822. See also 
Fluids management
balance, 602
choice, 644
DI, 387–389
disorders, 326–327
disturbances, 452, 647
homeostasis, 644
therapy, 556–557
Electromyography (EMG), 263, 418–420, 741, 
774, 843
Electrophysiologic dysfunction, 540
Electrophysiological testing, 738
Electrotherapy, 777
Elevated right atrial pressure, 265
Elevation of head of bed method, 555
Emboli, 136
Embolism, 265
Embolization, 225, 356, 359–360
Embryoblast cells, 41–42
Embryology, 41
Embryonic
disc, 42
germline stem cells, 908
pole, 41–42
stem cells, 908, 910
Emergence/emergency
agitation, 241, 250
from anesthesia, 240–241, 247
endocrine, 395
hypertension, 241
management
initial assessment, 571
interpretation of cervical spine 
radiograph, 571, 571f
of patients with supratentorial tumors, 
236–237
radiological investigations, 571
SCIWORA, 572
neurosurgery, 658
pregnancy, 677–678
Emergency room (ER), 798
management, 549–551
“Emesis center”, 248
Emetogenic effect, 261
EMG. See Electromyography (EMG)
Emotional sequelaes, 126
Empty Sella Syndrome, 382
preoperative assessment, 382
Encephaloceles, 632, 635–636, 635f
End diastolic area (EDA), 282
End diastolic volume (EDV), 282
End systolic volume (ESV), 282
End tidal carbon dioxide (ETCO2), 451, 759
End-of-life care, 958–961
care of dying patient, 960
DNR orders, 959
family issues, 960
future need, 961
physical care, 960
psychological care, 960
social care, 960
spiritual care, 961
withdrawal of life support measures, 
959–960
End-of-life issues
brain death, 607
DNR orders, 607, 865
medical futility, 607
in neurological critical care, 606–607
organ donation and related issues, 866
withdrawal of life support facility, 
865–866
withdrawal/withholding of care, 607
End-tidal carbon dioxide (EtCO2), 261, 
797–798
monitoring, 296, 708
Endocranium, 836
Endocrine, 757
emergency, 395
Endocrine diseases, 380–381
ACTH-secreting tumor, 381
growth hormone–secreting tumor, 381
hypothyroidism, 380
preparation of patient for surgery, 380
prolactinoma, 380–381
Endoderm, 43–44
Endogenous neuroprotectants, 543
Endonasal approach, 455
Endoscopes, reprocessing of, 935–938
anesthetic equipment, 936
cleaning, 937
disinfection, 937
humidifiers, 936
nebulizer, 936
processing of other scopes, 938
pulmonary screening device, 936
rinse and dry, 937
risk of nonendoscopic transmission of 
infection, 937–938
routine ventilator care, 935–936
store, 937
ventilators, 935
Endoscopic
endonasal approach advantages, 384
endoscopic-assisted clipping of 
aneurysms, 461
intraoperative and postoperative 
considerations, 462–463
endoscopic-assisted skull base surgery, 
457–458
spinal fusion, 463–464, 463f
strip craniectomy, 459–461, 460t–461t
surgery, 384
transsphenoidal hypophysectomy, 455
tumor excision, 458–459
Endoscopic third ventriculostomy (ETV), 21, 
453–454, 453f–454f, 471–472, 635
Endoscopy, 471
Endothelial cells, 645
anesthesia effects on, 53
Endothelial dysfunction, 543
Endothelial progenitor cells (EPCs), 775–776
Endothelin-1 receptor antagonists, 324–325
Endotracheal intubation, 549, 577
Endotracheal suctioning, 752
Endotracheal tube (ETT), 185, 261, 631–632
displacement, 201
Endovascular coiling, 327
anesthetic management of, 510–512
Endovascular intracranial aneurysm 
ablation, anesthesia management for, 
331–333
anesthesia technique, 332–333
conscious sedation, 332
general anesthesia, 332–333
technique, 332
Endovascular therapy, 355–356
Endovascular treatment, 360, 897–898
Index 1009
Energy failure, 540–541
Energy-dependent process, 76
Enflurane, 111, 289
ENIGMA II trial, 329
Enoxaparin, 351
Entropy sensor, 328
Environmental enrichment, 910
Environmental Protection Agency (EPA), 931
EOM. See Extraocular muscles (EOM)
EP. See Electrical potentials (EP)
EPA. See Environmental Protection Agency 
(EPA)
EPCs. See Endothelial progenitor cells 
(EPCs)
Ephedrine, 94, 262, 674
Epiblast, 42
Epidemiology
POCD, 661–663
SCI, 560–561
TBI, 536–537
Epidural
anesthesia, 742
catheters, 619–620
collections, 547, 571f
drug administration, 846–847
electrodes, 294
venous pressure, 673
Epidural hemorrhages (EDH), 539, 539f
Epilepsy, 222, 285, 793–794
anesthetic considerations, 793–794, 794t
effect of AEDs on anesthesia, 793, 793f
effect of anesthetic agents on epilepsy, 
794
anesthetic drugs effects on electrocorticog-
raphy monitoring, 497–498
anticholinergics and anticholinesterases, 
498
inhalational agents, 498
intravenous agents, 498
local anesthetics, 498
neuromuscular blocking agents, 498
opioids, 498
awake craniotomy for, 496–499
anesthetic techniques, 497
intraoperative anesthetic management, 
497
intraoperative electrocorticographic 
monitoring, 497
preoperative assessment, 496–497
rationale, 496
complications, 499
preoperative evaluation of patients with, 
222–223, 222t–223t
Epilepsy surgery (ES), 173, 286, 638, 649
AC, 295–299
AEDs interactions, 290–291
anesthesia for ES, 288
anesthetic agents effect in patients with 
epilepsy, 288–290
anesthetic management
of preoperative procedures, 292–293, 
294f
of resection of seizure focus, 295
neurostimulation for drug-resistant 
epilepsy, 301–302
preanesthetic evaluation and preparation, 
291–292, 293t
presurgical evaluation, 287–288
resection of epileptogenic focus under 
GA, 300–301
surgical management
of epilepsy, 286
types, 286–287, 287t
Epileptogenecity, 289
Epileptogenesis, 234
Epileptogenic focus under GA, resection of, 
300–301
Epinephrine, 708
Epithalamus, 15, 47
EPO. See Erythropoietin (EPO)“Epoch”, 144
Epsilon aminocaproic acid (EACA), 429
EPSP. See Excitatory postsynaptic potentials 
(EPSP)
EQ-5D. See EuroQol Index
Equality hypotheses, 986t
Equanox, 154–155, 155f
ER. See Emergency room (ER)
Erb–Goldflam syndrome, 735
EREM. See Extended-release epidural 
morphine (EREM)
Ergometrine, 678
Errors in hypothesis testing, 980
Erythropoetic stimulating agents 
(ESA), 422
Erythropoietin (EPO), 442
ES. See Epilepsy surgery (ES)
ESA. See Erythropoetic stimulating agents 
(ESA)
ESBL. See Extended-spectrum beta-lactamase 
(ESBL)
Esmolol, 252, 723
Esophageal echocardiography, 278
Estimation method, 979
ESV. See End systolic volume (ESV)
ETCO2. See End tidal carbon dioxide 
(ETCO2)
Ethical issues, 910–911
in clinical care, 863–866
medical ethics, 863
in neuroanesthesia practice, 863
relation
to innovative neurosurgery, 869
to research, 867–868
to team work, 868
to training, 868
Ethylene oxide (EtO), 935
Etiopathophysiology, 363
Etomidate, 82, 108, 173, 238, 289
cerebral effects, 105t, 108, 109f
current status, 108
other effects, 108
recent research, 108
ETT. See Endotracheal tube (ETT)
ETV. See Endoscopic third ventriculostomy 
(ETV)
European Organization for Research and 
Treatment of Cancer Quality of Life 
Questionnaire (EORTC QLQ-C30), 
967
EuroQol Index, 964–965
Euvolemia, 822
EVD. See External ventricular drainage 
(EVD)
Evidence-based guidelines, 553
Evidence-based medicine (EBM), 881–882
Evidence-based practice (EBP), 881–887
classifications of evidence, 882t
clinical pearls, 889
evidence and brain trauma foundation 
guidelines, 887, 888t
levels of evidence, 882t
unresolved issues in practice of neuroan-
esthesia, 887
Evidence-based pyramid, 882f, 883
Evidence-driven protocols, 316
Evoked potentials, 859
brain stem auditory evoked potential, 859
median nerve somatosensory evoked 
potential, 859
monitoring, 145–149, 362
for monitoring nervous system integrity, 
173
Excitatory amino acids (EAAs), 540
Excitatory movements, 288
Excitatory postsynaptic potentials (EPSP), 143
Excitotoxicity, 540–541
Experimental studies, 984
Expiratory muscle strength, 745
Explanatory variables, 994–995
Exposure variable, 978, 994–995
Extended-release epidural morphine 
(EREM), 847
Extended-spectrum beta-lactamase (ESBL), 
616
Extensive intraoperative dissection, 271
External defibrillation pads, 330
External ventricular drainage (EVD), 191, 
256, 322, 616–617
Extra-axial injuries, 546
epidural collections, 547, 571f
hydrocephalus, 548
IVH, 548
SAH, 548
subdural collections, 547
Extracellular fluid (ECF), 643, 815–816
Extrachoroidal secretion, 80
Extracranial vessels, 860
Extraocular muscles (EOM), 735
Extreme lateral interbody fusion (XLIF), 463
Extrinsic blood supply of spinal cord, 87–88
Extubation, 247, 249–251, 271, 331
F
4F-PCC. See Four-factor PCC (4F-PCC)
FAC. See Fractional area change (FAC)
Facial nerve injury, 263
FACT. See Functional assessment of cancer 
therapy (FACT); Functional 
Assessment of Chronic Illness 
Therapy (FACT)
FACT-Br. See Functional assessment of 
cancer therapy-brain (FACT-Br)
FACT-G. See General FACT module 
(FACT-G)
Index1010
Factor variable. See Exposure variable
Falx cerebella, 34
Falx cerebri, 34
Family meeting, 960
Fast-track awakening, 241
Fastigium, 22
Fasudil, 324
FDA. See Food and Drug Administration 
(FDA)
FE. See Focal epilepsy (FE)
Femoral artery, 341
catheterization, 340
femoral artery–femoral vein bypass, 331
Fentanyl, 125, 297, 676, 841, 920
Fertilization, 41
Fetal heart rate (FHR), 675
Fetal outcome, anesthetic agents effect on, 
673–674
Fetal stem cells, 908
Fetal toxicity, 525
FEV1. See Forced expiratory volume in 1 s 
(FEV1)
Fever, 619
FFP. See Fresh frozen plasma (FFP)
FHR. See Fetal heart rate (FHR)
Fiber-optic intubation, 426
Fiberoptic sensor, 140
Fibroelastomas, 699
Fibromas, 699
Fick principle, 139
Filum terminalis, 34
FiO2. See Fraction of inspired oxygen (FiO2)
First-line treatment, 312
Fissure of Rolando, 4
“Fitness for anesthesia”, 868
FLAIR. See Fluid-attenuated inversion 
recovery (FLAIR)
Floppy infant syndrome, 110
Flow arrest, 330, 356–357
adenosine-assisted cerebral blood flow 
arrest, 370–372
DHCA, 367–370
RVP–assisted cerebral blood flow arrest, 
372–373
Flow divertors, 327
Flow metabolism coupling, 72, 76
Flow velocity (FV), 73–74, 83
Fluid administration monitoring, 823
Fluid management, 633, 699, 815, 822–823
anatomy and physiology, 815–817
cerebral capillaries, 817f
blood transfusion, 823b
body fluid compartments, 816f
colloids, 820–821
in diabetes insipidus, 388
fluid abnormalities, 823–824
dyselectrolytemias, 824t
fluid therapy, 816b
hemodilution, 818
osmolarity calculation, 818b
osmosis, 817
osmotic pressure calculation, 818b
pathophysiology, 817
in pediatric neurosurgery, 645–646
Fluid-attenuated inversion recovery 
(FLAIR), 547
Fluid-filled external pressure transducer, 140
Fluid(s), 556–557
antibiotics, 557
balance, 602
choice, 644, 818
deep venous thrombosis, 557
disturbances in pediatric neurosurgery, 647
hypertonic, 818–820, 819t–820t
hypotonic, 821
infection, 557
isotonic, 820
loss management, 428–429, 428t
nutrition, 557
osmolarity and oncotic pressures of 
intravenous, 819t
resuscitation, 822
seizures, 557
therapy, 815, 816b
in neurosurgical patients, 885
type for perioperative administration in 
pediatric patients, 645, 645t
Flumazenil, 110, 125
Fluoromethyl 2,2,2-trifluoro-1-
[trifluoromethyl]ethyl ether, 113, 113f
Fluoroquinolones, 616, 621
Fluoroscopy, 331–332
fMRI. See Functional magnetic resonance 
imaging (fMRI)
Focal epilepsy (FE), 286
Focal injury, 538
“Focal motor status epilepticus”, 310
Focal neurologic deficit, 317
Follicle-stimulating hormone (FSH), 379
Food and Drug Administration (FDA), 
520, 933
Foramen of Luschka, 48
Foramen of Magendie, 48
Forced expiratory volume in 1 s (FEV1), 423
Force–frequency relationship, 775
Forensic medicine, 856
FOUR. See Full Outline of Unresponsiveness 
Scale (FOUR)
Four-factor PCC (4F-PCC), 349
Four-vessel cerebral angiography, 859
Fourth ventricle, 22
Fraction of inspired oxygen (FiO2), 261
Fractional area change (FAC), 282
Fragile brain, 127
Frames for positioning body in prone, 195–196
Andrew’s hinder–binder frame, 196, 196f
Relton and hall four poster frame, 196, 196f
Wilson supporting frame, 196
Framingham Heart Study, 653
FRC. See Functional residual capacity (FRC)
Free radicals, formation of, 564
Frequency domain, 150–151
Frequency-resolved spectroscopy, 154
Fresh frozen plasma (FFP), 349, 648
Frontal approaches, 236
Frontal eye field, 11
Frontal lobe, 5f, 6, 8b
Frontosphenotemporal, 329
Fructose-2, 6-biphosphate, 77
FSH. See Follicle-stimulating hormone (FSH)
Full Outline of Unresponsiveness Scale 
(FOUR), 549, 550t
Functional assessment, 655
Functional assessment of cancer therapy 
(FACT), 967
Functional assessment of cancer therapy-brain 
(FACT-Br), 967, 968f–969f
Functional Assessment of Chronic Illness 
Therapy (FACT), 964–965
Functional magnetic resonance imaging 
(fMRI), 520, 531–532
Functional neurosurgery, 479
anesthesia in patients with deep brain 
stimulator in situ, 486
anesthetic consideration, 481–484
anesthetic techniques, 484–485
complications, 485, 486t
position of patient during, 481f
procedure, 479–481
Functional reserve, 653
Functional residual capacity (FRC), 189
Functional stereotactic neurosurgery, 
657–658
Functional testing, 496
Furosemide, 677
FV. See Flow velocity (FV)
G
GA. See General anesthesia (GA)
GABA. See γ-Aminobutyric acid (GABA)
GABAA. See γ-Aminobutyric acid type A 
(GABAA)
Gabapentin, 761, 842, 845–846
Gacyclidine, 573
Gadolinium, 525
Gadolinium-based agents, 525
GALA trial, 362
Gametes, 41
Gamma knife radio surgery (GKRS), 516
Gamma knife stereotactic radiotherapy, 355
Gardner-Wells Tongs, traction systems, 197
GAS trial. See General Anesthesia Compared 
to Spinal Anesthesia trial (GAS trial)
Gastrointestinal ileus, 752
Gastrointestinal prophylaxis, 557–558
Gastrointestinal system, 671–672
Gastrointestinal tract, 757
dysfunction, 576
Gastrulation, 43–44
GBS.See Guillain–Barré syndrome (GBS)
GCS. See Glasgow Coma Scale (GCS)
GCSE. See Generalized convulsive status 
epilepticus (GCSE)
GDNF. See Glial-derived neurotrophic factor 
(GDNF)
Gel pads, 197, 201f
Gelatins, 820–821
solutions, 830–831
Gelofusine, 820
Gender in CBF, 73
General anesthesia (GA), 250, 288, 332–333, 
419, 424, 638, 742–743, 761
General Anesthesia Compared to Spinal 
Anesthesia trial (GAS trial), 900
General FACT module (FACT-G), 967
General ICU care, 350
Generalized convulsive status epilepticus 
(GCSE), 310–311, 313
Index 1011
Generalized tonic-clonic seizures (GTCS), 
289, 299
Generic health status, 964
Generic illness, 964–965
Genetic principles, 914
Geniculate nucleus, 13
Genu, 17, 18b
Geriatric neuroanesthesia. See also Pediatric 
neuroanesthesia
implications of surgical stress and 
anesthesia on elderly, 653
neurosurgical concerns unique to elderly, 
654–658
Geriatric neurosurgery, preoperative 
assessment for, 654–656
Geriatric neurosurgery and neurocritical 
care, palliation in, 658
Germ cells, 41
Germicide, 930
Germline stem cells, 908
GFAP. See Glial fibrillary acidic protein 
(GFAP)
GFR. See Glomerular filtration rate (GFR)
GH. See Growth hormone (GH)
Giant aneurysms, 331
Gibbs–Donnan equilibrium, 815–816
GKRS. See Gamma knife radio surgery (GKRS)
Glasgow Coma Scale (GCS), 211, 450–451, 
549, 550t, 587, 603, 630, 885
Glasgow Outcome Scale (GOS), 559, 559t, 589
GLAST. See Glutamate-aspartate transporter 
(GLAST)
Gliablasts, 46
Glial cells, 909
of spinal cord, 86
Glial fibrillary acidic protein (GFAP), 559, 589
Glial-derived neurotrophic factor (GDNF), 910
Global cerebral ischemia, 540–541
Glomerular filtration rate (GFR), 643–644
Glucocorticoids, 874
Glucose, 75, 715, 821
modes of glucose measurement, 714
solutions, 828
variability, 94–95
Glucose Insulin Stroke Trial, 717
Glucose-containing fluids, 633
Glutamate, 76, 124, 715
Glutamate-aspartate transporter (GLAST), 124
Glutamatergic signaling, 52–53
Glycemic control, 885, 893
in neurosurgical subsets, 717
regimens, 720
Glycemic indices, 714
Glycemic management, 719
Glycine, 86
Glycolytic enzyme, 590
Glycopyrrolate, 739
Glycosylated hemoglobin (HbA1C), 718
GM-1 ganglioside, 573
Goal-directed fluid therapy, 831
Gold standard methods, 164
Goldenhar syndrome, 412
Gonadotropin function, 382
GOS. See Glasgow Outcome Scale (GOS)
Gradient coil, 522–523
Gravid uterus, 672–673
Gray rami communicantes, 49–50
GRH. See Growth hormone–releasing 
hormone (GRH)
Gross structural pathology, 312
Group sequential designs, 985–987
Growth factors, 910
Growth hormone (GH), 376
Growth hormone–releasing hormone 
(GRH), 379
Growth hormone–secreting tumor, 381
Growth of cell, 41
GTCS. See Generalized tonic-clonic seizures 
(GTCS)
Guillain–Barré syndrome (GBS), 599, 734, 
748, 788–789, 857. See also 
Lambert–Eaton myasthenic syndrome 
(LEMS)
anesthetic considerations, 753, 788t, 789
clinical features, 749
differential diagnosis, 750, 750t
epidemiology, 749
laboratory investigations, 750–751
natural history and prognosis, 750
prognosis, 753
subtypes, 749–750
supportive care, 752
treatment, 751–752
Gupta MICA-NSQIP database risk 
model, 211
H
Habenular nucleus, 15–16
afferent fibers, 16
efferent fibers, 16
Habenular trigone, 15
Haemaccel, 820
HAI. See Health care–associated infections 
(HCAI)
Halogenated inhalational anesthetics, 916
Haloperidol, 665–666
Halothane, 111, 125, 631
Hamartomatous lesions, 291–292
Hand hygiene, 946
Hazards
of immobilization, 570
related to MRI, 524–526
contrast–related hazards, 525
to high-power magnetic field, 524
image acquisition–related hazards, 525
in patients with CIEDs, 526
Hb. See Hemoglobin (Hb)
HbA1C. See Glycosylated hemoglobin 
(HbA1C)
HBV. See Hepatitis B virus (HBV)
HCAI. See Health care–associated infections 
(HCAI)
Hct. See Hematocrit (Hct)
HCV. See Hepatitis C virus (HCV)
HD. See Huntington disease (HD)
Head injury, 82, 137, 537, 669
anesthetic management of patients with
with life-threatening extracranial injury, 
798, 799t
for non-life threatening extracranial 
injury, 799–800
surgical treatment, 552–553, 553t
Head positioning, 187
alignment of head and neck
elevation of head, 187
fixation of head, 188–189
flexion and extension of head, 187
horse shoe head rest, 189
MFK skull fixation device, 188, 188f
monitoring during head and neck 
positioning, 187–188
rotation of head, 187
Sugita multipurpose head frame, 188, 188f
equipment for stabilizing head, 197
dough nut–shaped foam/gel pads, 197
Gardner-Wells Tongs, traction systems, 
197
prone pillows, 197, 197f
Headache, 317, 686
Headrest syndrome, 201–202
Health care–associated infections (HCAI), 
940, 945
prophylactics in ICU, 946
Health statistics, 976
Health-related quality of life (HRQoL), 
963–964
in patients with brain tumors, 967
in relation to neurosurgical/neurological 
conditions, 965–967
Neuro-QOL, 966
QOLIBRI-OS, 966–967
after subarachnoid hemorrhage, 966–967
tools for measuring, 964–965
combined instruments for patient-
reported outcomes, 965
uses of measuring, 965
utility, 964
Heart, tumors of, 699
Heart rate (HR), 451, 509–510
Heart rate variability (HRV), 601, 859
Heat shock protein 70 (HSP 70), 543
Heat–moisture exchanger (HME), 936
Hemangioblastomas, 649
Hematocrit (Hct), 73
effects, 73
values, 239
Hematoma, 242, 251, 346
evacuation, 350–351
Hemiballismus, 16
Hemispherectomies, 301
Hemodilution, 818, 824
Hemodynamic(s), 162–171, 239, 280, 342
arterial blood pressure, 162–163
cardiac output, 163–164
changes, 808–809
consideration, 677
factors, 225
hemoglobin concentration, 164–165
instability, 237, 262
intravascular volume status, 164, 165f
management, 262–263
manipulations in vaso-occlusive 
conditions, 599–600
monitoring in prone position, 199
NIRS, 166–168
perturbations, 456
SjvO2, 166, 167t
TCDU, 168–171
Index1012
Hemoglobin (Hb), 73, 887. See also Blood
concentration, 164–165, 165t
Hemopoetic system, 422
Hemorrhage, 353
contusions, 546
tissue, 395
Hemosiderin, 548
Hensen’s node, 43–44
HEPA. See High-efficiency particulate air 
(HEPA)
Heparin, 340–341, 351, 515, 674, 688–689
Hepatic encephalopathy, 137
Hepatic evaluation, 422
Hepatic system, 673
Hepatitis B virus (HBV), 930
disinfection of, 938–939
Hepatitis C virus (HCV), 938
disinfection of, 938–939
Herniation syndromes, 548, 548t
HES. See Hydroxyethyl starch (HES)
Hetastarch, 823
Heterotopic ossification, 567
HFOs. See High-frequency oscillations (HFOs)
HIF-1α. See Hypoxia inducible factor-1α 
(HIF-1α)
High ICP, 141, 141f
High intensity transient signals, 170, 171f
High-dose barbiturates, 56
High-dose penicillin, 616
High-efficiency particulate air (HEPA), 932
High-frequency oscillations (HFOs), 300
High-level disinfectant (HLD), 930
High-power magnetic field, 524
hazards related to RF field, 525
High-risk spine surgeries (HRSS), 424
HIMALAIA trial, 323
Hippocampus, 46–47
Histamine, 114
HIV. See Human immunodeficiency virus 
(HIV)
HLD. See High-level disinfectant (HLD)
HME. See Heat–moisture exchanger (HME)
Homogeneous magnetic field, 523
Hormonal hypersecretion, 380
Hormonal resuscitation regime, 875t
Hormonal therapy, 772
Hormone replacement, 389
Horse shoe head rest, 189
Hospital-acquired infection, 940
HPA axis. See Hypothalamic-pituitary-
adrenal axis (HPA axis)
HPP. See Hydrogen peroxide plasma-based 
(HPP)
HR. See Heart rate (HR)
HRQoL. See Health-related quality of life 
(HRQoL)
HRSS. See High-risk spine surgeries (HRSS)
HRV. See Heart rate variability (HRV)
HS. See Hypertonic saline (HS)
HSP 70. See Heat shock protein 70 (HSP 70)
5HT3. See 5-Hydroxytryptamine type 3 
receptor (5HT3)
5-HT3 antagonists, 242
Human immunodeficiency virus (HIV), 935
disinfection of, 938–939
Human plasma, 830
Humidifiers, 936
Hunt and Hess classification, 319
Huntington chorea, 764
Huntington disease (HD), 16–17, 764–765, 
787–788
anesthetic considerations, 787–788, 787t
effect of disease on anesthetic agents, 
787–788
Hydralazine, 724
Hydrocephalus, 83, 256, 322, 548, 633–635, 
634f, 634t
Hydrocodone, 919
Hydrogen