Rao Shilpa, Avitsian Rafi
Department of Anesthesiology, Yale School of Medicine and Yale New Haven Hospital, 333 Cedar Street, TMP 3, PO Box 208051, New Haven, CT 06520-8051, USA.
Department of General Anesthesiology, Cleveland Clinic Foundation, 9500 Euclid Avenue # E31, Cleveland, OH 44195, USA.
Anesthesiol Clin. 2020 Mar;38(1):67-83. doi: 10.1016/j.anclin.2019.10.004.
Neurosurgical procedures are unique in that the best monitoring modality is the neurologic examination and the most important sign includes an intact mental status. Anesthesiologists play a vital role in medical management of neurosurgical emergencies. The authors discuss the important management strategies for these emergencies, including increased intracranial pressure and impending brain herniation, acute alteration of mental status, status epilepticus, and trauma to cervical spine. The key is to maintain cerebral and spinal cord perfusion pressure at all times to salvage neuronal recovery.
神经外科手术具有独特性，因为最佳的监测方式是神经学检查，而最重要的体征包括精神状态完好。麻醉医生在神经外科急诊的医疗管理中发挥着至关重要的作用。作者讨论了这些急诊的重要管理策略，包括颅内压升高和即将发生的脑疝、精神状态的急性改变、癫痫持续状态以及颈椎创伤。关键是要始终维持脑和脊髓的灌注压以挽救神经元恢复。
