Neurologic disorders requiring surgical intervention more and more caused by traumatic brain injury, haemorrhagic strokes, or brain tumors. The anesthetic management of these patients can be complicated by the signifcant maternal physiologic changes that occurs during pregnancy. These changes may require alteration in anesthetics management that would considered inappropriate for a nonpregnant …
Background and Objective: Postoperative agitation is a problem that sometimes occurs in patients who underwent general anesthesia. There is still controversy about the relative advantages of the use of perioperative desflurane or sevoflurane inhalation as maintenance of anesthesia in ambulatory surgical patients. This study aims to determine the comparative magnitude of the incidence of postope…
Hemorrhagic stroke is devastating disease and only 30% patients survive in 6 months after event. The comm on cause of intracranial hemorrhage are subarachnoid hemorrhage (SAH) from aneurysm, bleeding from arteriovenous malformation (AVM) or intracerebral hemorrhage. Intracecerebral hemorrhage common correlation with hypertension, anticoagulant therapy, or other coequlopethi, and alcohol addict,…
Traumatic Brain Injury (TBI) morbidit), and mortality are due to primary and secondary injury. Primary injury is due to mechanical forces during the trauma process and secondary injury is subsequent process following the primary impact. This secondary injury processes involving increased excitatory amino acids, ionic imbalance, decreased ATP level, unusual proteolytic enzyme activity, and oxida…
Tetralogy of Fallot (TOF) was jirst described in 1888 by a French physician named Etienne-Louis Arthur Fallot. Tetralogy of Fallot (TOF) is one type of cyanotic congenital heart defect most widely found. Tetralogy of Fallot (TOF) has four abnormalities: (1) pulmonary infundibulum stenosis, (2) VSD (Ventricular Septal Defect), (3) overriding aorta, and (4) right ventricular hypertrophy. Patients…
Neuroendocrine tumor is commonly in adult patient with incidence 10-15% in all of intracranial neoplasm and highest at 4th-6th of life decade. Patients with neuroendocrine tumor have an unique challange for anesthesiologist because the important role of pituitary gland in endocrine system. The challange came during preoperative, intraoperative and postoperative periode. Many of anesthesia t…
The brain is the body's vital organs are susceptible to damage. Have a high oxygen demand, is highly dependent on glucose, has a high metabolic rate, but have low adaptability of the injury and it is very difficult to regeneration. Injury on brain cells (neurons) is a serious condition because of risk for dysfunction and cells death. The brain needsfor oxygen and glycogen constanly to produce…
Craniopharyngioma is a sellar and parasellar tumor, which accounts to 6-10% of childhood brain tumors. Common symptoms are signs of increase intracranial pressure, like headache, vomiting and visual dysfunction. A signijicant endocrine dysfunction is an usual feature of craniopharyngioma due to the proximity of the tumor to hypothalamus and pituitary gland. Short statue found in 50-86% patient …
Trauma during pregnancy, including head injury, is the leading cause of accidental maternal death and morbidity, and complicates 6%-7% of all pregnancies which requires multidisciplinary patient's management. The anesthesiologist must understand the physiological changes of pregnancy, their implications, and the specific risks of anesthesia during pregnancy, so that the best anesthetic approach…
During Traumatic brain injury, secondary insults will led to physiological and biochemical cascade that disturbing cerebral energy metabolism. After traumatic brain injury, sustained changes in cellular energy metabolism have been described as accelerated glycolysis or mitochondrial dysfunction. Traumatic brain injury is associated with increasing energy needs to res tore cerebral ionic hemosta…