Craniotomy

Publication Title: 
Bulletin of the History of Medicine

By 1800, the Roman Catholic Church and organized medicine faced the dilemma of how to resolve cases of obstructed births. American physicians usually practiced destructive operations, like craniotomy, in an attempt to save the lives of mothers. The church allowed such operations after the death of the infant. A new technique of surgery, the cesarean operation, offered hope that both patients would survive childbirth.

Author(s): 
Ryan, Joseph G.
Publication Title: 
Journal of Neurosurgical Anesthesiology

Propofol is alleged to possess both pro- and anticonvulsant properties, leading to controversy regarding its use in patients with a history of seizures. Since propofol is administered for both sedation and hypnosis, it is important to understand the effects of low (0.5-1.0 mg/kg) and high (2-2.5 mg/kg) doses of propofol on the electroencephalogram (EEG). In this study, the hemodynamic and EEG effects of cumulative doses of propofol from 0.5 to 2.5 mg/kg i.v. were studied in 30 neurosurgical patients with or without a history of seizure disorders.

Author(s): 
Wang, B.
Bai, Q.
Jiao, X.
Wang, E.
White, P. F.
Publication Title: 
Anesthesia and Analgesia

BACKGROUND: The perioperative course of patients undergoing intracranial surgery is frequently complicated by hypertensive episodes. Dexmedetomidine (DEX), an alpha-2 adrenoreceptor agonist, is gaining popularity in neuroanesthesia, because its sympatholytic and antinociceptive properties may improve hemodynamic stability at critical moments of surgery. We designed this study to assess the efficacy of DEX in controlling hypertensive responses in patients undergoing intracranial surgery.

Author(s): 
Bekker, Alex
Sturaitis, Mary
Bloom, Marc
Moric, Mario
Golfinos, John
Parker, Erik
Babu, Ramesh
Pitti, Abishabeck
Publication Title: 
Journal of Anesthesia

We report a patient with Parkinson's disease undergoing craniotomy for a brain tumor, who had clinically adequate hypnosis at a very low concentration of isoflurane. While the raw EEG showed low-voltage slow electrical activity, the EEG analyzer of the monitor displayed high burst suppression ratios. The role of intracranial pathology and drug therapy as possible causes of the low anesthetic requirement for adequate hypnosis are discussed. This report also draws attention to the possibility of erroneous analysis of burst suppression by EEG modules.

Author(s): 
Jaganath, Amruthalingam
Ramesh, Mukkanna
Radhakrishnan, Muthuchellappan
Umamaheswara Rao, Ganne S.
Publication Title: 
Journal of Neurosurgery

OBJECT: Chiropractic manipulation of the cervical spine is a known cause of craniocervical arterial dissections. In this paper, the authors describe the patterns of arterial injury after chiropractic manipulation and their management in the modern endovascular era. METHODS: A prospectively maintained endovascular database was reviewed to identify patients presenting with craniocervical arterial dissections after chiropractic manipulation.

Author(s): 
Albuquerque, Felipe C.
Hu, Yin C.
Dashti, Shervin R.
Abla, Adib A.
Clark, Justin C.
Alkire, Brian
Theodore, Nicholas
McDougall, Cameron G.
Publication Title: 
Trials

BACKGROUND: The incidence of postoperative nausea and vomiting (PONV) is 50 to 79% after neurosurgery. Our study is designed to evaluate the efficacy of pericardium 6 (P6; also known as Neiguan) acupoint stimulation versus placebo, and versus routine antiemetic for the prevention of PONV after craniotomy, as well as to compare the efficacy of invasive acupuncture with non-invasive transcutaneous electrical nerve stimulation (TENS) on P6. METHODS/DESIGN: This is a single-center, prospective, double-blind, five-arm, parallel-group, randomized controlled trial (RCT).

Author(s): 
Lv, Jian-qin
Feng, Rui-zhi
Li, Ning
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