Preface
M. Dustin Boone, MD Beth Israel Deaconess Medical Center, Boston, Massachusetts
This volume on Neuroanesthesia was written with the goal of providing the consultant anesthesiologist an up-to-date resource for a rapidly evolving subspecialty. Experts in the neuroscience subspecialties (anesthesia, neurology, neurosurgery, neuroradiology, and neurocritical care) contributed to this effort. In many cases, authors from these subspecialties collaborated to coauthor manuscripts. This collaborative approach is what draws many to the field of neuroanesthesia; that is, to be a “complete” neuroanesthesiologist, one must be familiar with concepts from a variety of fields in neuroscience. There is relatively little written about the preoperative evaluation of the neurosurgical patient. With this in mind, the first chapter on neurosurgical preoperative evaluation helps to anchor subsequent topics. We continue to care for an increasingly complex patient population—those taking novel oral anticoagulants, or with advanced movement disorders—and this chapter helps to answer some of these questions. What I find particularly interesting about this field is how modernday neuroscience continues to build upon historical discoveries. Nearly 200 years ago, Professors Alexander Monro and George Kellie1,2 introduced the concept of elevated intracranial pressure. The practical relevance to this discovery has not changed, although we have yet to elucidate the optimal manner in which to treat intracranial hypertension. Several chapters in this volume expand on this very basic concept, now known as the Monro-Kellie doctrine, by discussing stateof-the-art neuromonitoring as it applies to both the operating room and the intensive care unit. As is the case with many other surgical subspecialties, an increasing number of neurosurgeries are being performed in remote locations. The endovascular management of cerebrovascular disease, including cerebral aneurysms and acute stoke, is presented in 2 chapters, one
REPRINTS: M. DUSTIN BOONE, MD, BETH ISRAEL DEACONESS MEDICAL CENTER, ONE DEACONESS ROAD, BOSTON, MA 02215. E-MAIL: [email protected] INTERNATIONAL ANESTHESIOLOGY CLINICS Volume 53, Number 1, vii–viii r 2015, Lippincott Williams & Wilkins
www.anesthesiaclinics.com | vii
viii
’
Preface
from the surgical perspective and a second that highlights some unique challenges to the anesthesiologist. Finally, the neuroanesthesiologist is frequently providing neurocritical care. In fact, few other subspecialties within anesthesia demand expertise in both the operating room and the intensive care unit. To that end, the final chapter, which discusses neurocritical care, addresses potential postoperative problems. We are better able to care for our patients perioperatively with this insight.
The author declares that there is nothing to disclose.
’
References
1. Monro A. Observations on the Structure and Function of the Nervous System. Edinburgh: Creech & Johnson: 1823;5. 2. Kellie G. An account of the appearances observed in the dissection of two of the three individuals presumed to have perished in the storm of the 3rd, and whose bodies were discovered in the vicinity of Leith on the morning of the 4th November 1821 with some reflections on the pathology of the brain. Trans Med Chir Soc Edinb. 1824;1: 84–169.
www.anesthesiaclinics.com
M. Dustin Boone, MD Beth Israel Deaconess Medical Center, Boston, Massachusetts
This volume on Neuroanesthesia was written with the goal of providing the consultant anesthesiologist an up-to-date resource for a rapidly evolving subspecialty. Experts in the neuroscience subspecialties (anesthesia, neurology, neurosurgery, neuroradiology, and neurocritical care) contributed to this effort. In many cases, authors from these subspecialties collaborated to coauthor manuscripts. This collaborative approach is what draws many to the field of neuroanesthesia; that is, to be a “complete” neuroanesthesiologist, one must be familiar with concepts from a variety of fields in neuroscience. There is relatively little written about the preoperative evaluation of the neurosurgical patient. With this in mind, the first chapter on neurosurgical preoperative evaluation helps to anchor subsequent topics. We continue to care for an increasingly complex patient population—those taking novel oral anticoagulants, or with advanced movement disorders—and this chapter helps to answer some of these questions. What I find particularly interesting about this field is how modernday neuroscience continues to build upon historical discoveries. Nearly 200 years ago, Professors Alexander Monro and George Kellie1,2 introduced the concept of elevated intracranial pressure. The practical relevance to this discovery has not changed, although we have yet to elucidate the optimal manner in which to treat intracranial hypertension. Several chapters in this volume expand on this very basic concept, now known as the Monro-Kellie doctrine, by discussing stateof-the-art neuromonitoring as it applies to both the operating room and the intensive care unit. As is the case with many other surgical subspecialties, an increasing number of neurosurgeries are being performed in remote locations. The endovascular management of cerebrovascular disease, including cerebral aneurysms and acute stoke, is presented in 2 chapters, one
REPRINTS: M. DUSTIN BOONE, MD, BETH ISRAEL DEACONESS MEDICAL CENTER, ONE DEACONESS ROAD, BOSTON, MA 02215. E-MAIL: [email protected] INTERNATIONAL ANESTHESIOLOGY CLINICS Volume 53, Number 1, vii–viii r 2015, Lippincott Williams & Wilkins
www.anesthesiaclinics.com | vii
viii
’
Preface
from the surgical perspective and a second that highlights some unique challenges to the anesthesiologist. Finally, the neuroanesthesiologist is frequently providing neurocritical care. In fact, few other subspecialties within anesthesia demand expertise in both the operating room and the intensive care unit. To that end, the final chapter, which discusses neurocritical care, addresses potential postoperative problems. We are better able to care for our patients perioperatively with this insight.
The author declares that there is nothing to disclose.
’
References
1. Monro A. Observations on the Structure and Function of the Nervous System. Edinburgh: Creech & Johnson: 1823;5. 2. Kellie G. An account of the appearances observed in the dissection of two of the three individuals presumed to have perished in the storm of the 3rd, and whose bodies were discovered in the vicinity of Leith on the morning of the 4th November 1821 with some reflections on the pathology of the brain. Trans Med Chir Soc Edinb. 1824;1: 84–169.
www.anesthesiaclinics.com
