Anaesthesia for neurovascular surgery and the management of ischaemic stroke

Neurovascular anaesthesia covers the preoperative period, during which resuscitation and stabilization are crucial, the treatment of the lesion, either in the operating theatre or radiology suite, and the postoperative treatment which aims to reduce long-term morbidity. Throughout these periods care involves assuring adequate oxygenation and perfusion to the area of brain injury, as well as reducing the incidence of re-bleeding and other complications. Therapeutic procedures for intracranial aneurysms usually consist of either surgical clipping or endoscopic coiling before or after a subarachnoid haemorrhage. Embolization, radiosurgery, surgical excision or a combination of these modalities is used to treat arteriovenous malformations (AVMs). Most haematoma following intracranial haemorrhage are evacuated surgically, depending on the location of the haematoma and the clinical condition of the patient.