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Chronic Use of Angiotensin Converting Enzyme Inhibitors and/or Angiotensin Receptor Blockers is Not Associated With Stroke After Noncardiac Surgery: A Retrospective Cohort Analysis
Conclusion: We did not detect an effect of chronic ACEI/ARB use on postoperative strokes in patients who had non-neurological, noncarotid and noncardiac surgery; however, power was extremely limited.
Source: Journal of Neurosurgical Anesthesiology - September 16, 2022 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Effect of Intensive Glucose Control on Outcomes of Hyperglycemic Stroke Patients Receiving Mechanical Thrombectomy: Secondary Analysis of the SHINE Trial
Conclusions: Intensive blood glucose control among AIS patients presenting with hyperglycemia and treated with MT was not associated with lower rates of death or higher rates of long-term favorable outcomes when compared with standard treatment.
Source: Journal of Neurosurgical Anesthesiology - September 16, 2022 Category: Anesthesiology Tags: Short Reports Source Type: research

Revised Use of the Modified National Institutes of Health Stroke Scale for Perioperative Stroke Screening
No abstract available
Source: Journal of Neurosurgical Anesthesiology - June 17, 2022 Category: Anesthesiology Tags: Editorials Source Type: research

Intensive Care Admission and Management of Patients With Acute Ischemic Stroke: A Cross-sectional Survey of the European Society of Intensive Care Medicine
Conclusions: The ICU management of AIS, including therapeutic targets and clinical practice strategies, importantly varies between centers. Our findings may be helpful to define future studies and create a research agenda regarding the ICU therapeutic targets for AIS patients.
Source: Journal of Neurosurgical Anesthesiology - June 17, 2022 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Postoperative Screening With the Modified National Institutes of Health Stroke Scale After Noncardiac Surgery: A Pilot Study
Background: Perioperative stroke is associated with high rates of morbidity and mortality, yet there is no validated screening tool. The modified National Institutes of Health Stroke Scale (mNIHSS) is validated for use in nonsurgical strokes but is not well-studied in surgical patients. We evaluated perioperative changes in the mNIHSS score in noncardiac, non-neurological surgery patients, feasibility in the perioperative setting, and the relationship between baseline cognitive screening and change in mNIHSS score. Methods: Patients aged 65 years and above presenting for noncardiac, non-neurological surgery were...
Source: Journal of Neurosurgical Anesthesiology - June 17, 2022 Category: Anesthesiology Tags: Short Reports Source Type: research

Role of Dexmedetomidine in Aneurysmal Subarachnoid Hemorrhage: A Comprehensive Scoping Review
Dexmedetomidine (DEX), an α2-adrenergic agonist, has been widely used for anesthesia, pain control, and intensive care unit sedation. Besides sleep-like sedation, DEX has many other beneficial effects, such as anti-inflammation, antioxidation, and anticell death. Subarachnoid hemorrhage (SAH), a severe and potentially fatal form of stroke, is a complex disease that is divided into 2 phases: early brain injury and delayed cerebral ischemia. In each phase, several pathologic changes are involved, including disturbed intracranial homeostasis, metabolic failure, blood-brain barrier damage, vasospasm, microthrombosis, and cort...
Source: Journal of Neurosurgical Anesthesiology - March 15, 2022 Category: Anesthesiology Tags: Review Articles Source Type: research

Hemoglobin Concentration May Influence the Incidence of Postoperative Transient Neurological Events in Patients With Moyamoya After Extracranial-intracranial Arterial Bypass: A Retrospective Single Center Experience
Background: Moyamoya is a rare condition characterized by cerebral angiographic findings of intracranial carotid artery stenosis with abnormal net-like vessels in the brain, and often presents as transient ischemic attacks or intracranial hemorrhage. Revascularization in the form of extracranial-intracranial (EC-IC) artery bypass has demonstrated efficacy in preventing ischemic attacks and intracranial hemorrhage, although it is associated with a relatively high rate of perioperative ischemic and hemorrhagic stroke. This retrospective analysis aims to evaluate the possible association between postoperative hemoglobin (...
Source: Journal of Neurosurgical Anesthesiology - March 15, 2022 Category: Anesthesiology Tags: Short Reports Source Type: research

Choice of ANesthesia for EndoVAScular Treatment of Acute Ischemic Stroke (CANVAS): Results of the CANVAS Pilot Randomized Controlled Trial: Erratum
No abstract available
Source: Journal of Neurosurgical Anesthesiology - March 15, 2022 Category: Anesthesiology Tags: Erratum Source Type: research

Precision Medicine in Acute Brain Injury: A Narrative Review
Over the past few years, the concept of personalized medicine has percolated into the management of different neurological conditions. Improving outcomes after acute brain injury (ABI) continues to be a major challenge. Unrecognized individual multiomic variations in addition to multiple interacting processes may explain why we fail to observe comprehensive improvements in ABI outcomes even when applied treatments appear to be beneficial logically. The provision of clinical care based on a multiomic approach may revolutionize the management of traumatic brain injury, delayed cerebral ischemia after subarachnoid hemorrhage,...
Source: Journal of Neurosurgical Anesthesiology - December 13, 2021 Category: Anesthesiology Tags: Review Articles Source Type: research

Early Goal-directed Therapy During Endovascular Coiling Procedures Following Aneurysmal Subarachnoid Hemorrhage: A Pilot Prospective Randomized Controlled Study
Conclusions: A high proportion of aSAH patients presented at the coiling procedure with dehydration and a low cardiac output state; these derangements were more likely to be corrected if the GDT algorithm was used. Compared with standard therapy, use of the GDT algorithm resulted in earlier recognition and more consistent treatment of dehydration and hemodynamic derangement during endovascular coiling.
Source: Journal of Neurosurgical Anesthesiology - December 13, 2021 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Assessment of Anesthesia Practice Patterns for Endovascular Therapy for Acute Ischemic Stroke: A Society for Neuroscience in Anesthesiology and Critical Care (SNACC) Member Survey
Conclusions: There is wide variation in anesthesia technique and hemodynamic management during EVT for AIS, and no consensus on the choice of, or preferred medications for, GA or CS, or target blood pressure and management of hypotension during the procedure.
Source: Journal of Neurosurgical Anesthesiology - September 19, 2021 Category: Anesthesiology Tags: Short Reports Source Type: research

Management of Endovascular Treatment for Acute Ischemic Stroke During the COVID-19 Pandemic at a Single Institution in Beijing, China: A Brief Report
Background: The coronavirus disease (COVID-19) pandemic is currently a major challenge for health care systems around the world. For a time-sensitive emergency such as acute ischemic stroke (AIS), streamlined workflow times are essential to ensure good clinical outcomes. Methods: The aim of this single-center, retrospective, observational study was to describe changes in stroke workflow patterns and clinical care during the COVID-19 pandemic. Data from AIS patients undergoing emergent endovascular treatment (EVT) between 23 January and 8 April 2020 were retrospectively collected and compared with data from patie...
Source: Journal of Neurosurgical Anesthesiology - June 18, 2021 Category: Anesthesiology Tags: Short Reports Source Type: research

Neuroanesthesiology Update
This review summarizes the literature published in 2020 that is relevant to the perioperative care of neurosurgical patients and patients with neurological diseases as well as critically ill patients with neurological diseases. Broad topics include general perioperative neuroscientific considerations, stroke, traumatic brain injury, monitoring, anesthetic neurotoxicity, and perioperative disorders of cognitive function.
Source: Journal of Neurosurgical Anesthesiology - March 11, 2021 Category: Anesthesiology Tags: Review Article Source Type: research

Site of Occlusion May Influence Decision to Perform Thrombectomy Under General Anesthesia or Conscious Sedation
Background: Although mechanical thrombectomy has become the standard of care for large-vessel occlusion, the role of conscious sedation versus general anesthesia (GA) with intubation during thrombectomy remains controversial. Aphasia may increase patient agitation or apparent uncooperativeness/confusion and thereby lead to higher use of GA. The purpose of this study was to identify risk factors for GA and determine if the side of vessel occlusion potentially impacts GA rates. Materials and Methods: Patients who underwent mechanical thrombectomy of the middle cerebral artery (MCA) for acute ischemic stroke at our...
Source: Journal of Neurosurgical Anesthesiology - March 11, 2021 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

General Anesthesia Versus Conscious Sedation in Endovascular Thrombectomy for Stroke: A Meta-analysis of 4 Randomized Controlled Trials
Conclusions: In centers with high quality, specialized neuroanesthesia care, GA treated thrombectomy patients had superior recanalization rates and better functional outcome at 3 months than patients receiving CS.
Source: Journal of Neurosurgical Anesthesiology - December 11, 2020 Category: Anesthesiology Tags: Review Articles Source Type: research

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