Anesthesia for Neurosurgery

H HOSSEINI MD

SKULL

BRAIN

FORAMEN MAGNUM

The Vertebral Column Or Spinal Column

Neurophysiology

•ICP< 15cmH2o•CBF= 15-20% of C.O.=50ml/100gr• CMRO2=3-3.8 ml/100gr• CSF production=500-600 ml/day•Brain+CSF+blood=1200-1500 ml•Normal ICP=15-20 cmH2o•1mmHg↓↑PaCO2 from40 mmHg→ ↓↑ 1ml/100gr/mint CBF•1◦C↓T under 37◦C→7%↓CBF

CEREBRAL PERFUSION PRESSURE

CPP=MAP-ICP or CVP

CEREBRAL VASOSPASM