Anaesthesia for interventional neuroradiology

The scope of interventional neuroradiology has expanded enormously recently; in addition to treating intracranial aneurysms, arteriovenous malformations (AVMs) and dural fistulae, there is increasing involvement in the embolization of tumours, intra- and extracranial angioplasty and stenting, therapeutic carotid occlusion for giant aneurysms and skull base tumours and the treatment of cerebral vasospasm and stroke. An appreciation of the physiological requirements and potential problems relating to individual procedures allows the close cooperation between anaesthetist and radiologist that is essential for a good outcome. This attention to detail must extend into the post-procedural period when the patients should be recovered in an environment where close attention to neurological examination and the recognition of potentially subtle changes warranting action must be appreciated.