Neuro Yoa Flashcards
- What is the pathology of intracranial tumors?
What is intracranial pressure (ICP), and what are its
determinants?
How does the presence of a mass alter the ICP in this patient,
and what are the clinical manifestations of these alterations?
What is cerebral blood flow (CBF), and what are its
determinants?
What are the cerebral steal syndromes?
. Are there any issues specific to posterior cranial fossa
pathology?
What is the role of preoperative embolization therapy?
What are the special considerations in preoperative evaluation
of the patient scheduled for posterior fossa craniotomy?
In a patient who presents with intracranial hypertension, what
management might have already been initiated preoperatively,
and what are the implications for anesthetic management?
What are the types of intraoperative neurophysiologic
monitoring (IOM) that would likely be used for this procedure,
and how will they affect the anesthetic management plan?
What are the options for patient positioning during posterior
fossa surgery?
What are the principal disadvantages associated with the
common posterior fossa craniotomy positions?
How does the sitting position affect your preoperative
assessment and planning?
What are the anesthetic goals for craniotomy?
What monitors should be used during craniotomy?
Would you monitor for venous air embolism (VAE)? What are
the monitoring options?
Would you monitor for venous air embolism (VAE)? What are
the monitoring options?
What specific risks are associated with induction of
anesthesia?
How would you induce anesthesia?
What are the effects of anesthetics on cerebral metabolic rate
of oxygen (CMRO2), CBF, and ICP? With this in mind, how
would you maintain anesthesia?
How would you manage ventilation and maintain arterial
carbon dioxide (CO2)?
How would you approach diuretic therapy?
How would you manage serum glucose?
How would you approach fluid management?
Once the bone plate is removed and the dura
retracted, the surgeon reports that the brain is still
“tight.” What would be your response?
If deliberate hypotension is indicated, how will you
achieve it?
While the surgeon is resecting tumor from near the
brainstem, the patient’s heart rate suddenly drops to
20 beats per minute. What is your assessment and
management?
Are there any measures you can take to prevent
VAE?
During the procedure, the precordial Doppler
becomes loud and turbulent. The end-tidal CO2
(EtCO2) drops from 31 to 13 mmHg, and the systemic
pressure from 121/63 to 64/32 mmHg. What is your assessment and management plan?
What is your approach to emergence? What if the
patient does not regain consciousness?
What postoperative complications are of greatest
concern? What level of monitoring is required?
What is your approach to postoperative pain
control?
In the ICU, the patient’s neurologic status
deteriorates and ICP monitoring is instituted. What
are the different methods of monitoring ICP, and
what are their limitations?