الفهرس 
Anatomy of Cerebral CirculationOnly 14 pages are availabe for public view
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Abstract
Structural vessel wall abnormalities may predispose to aneurysm formation and known risk factors include atherosclerosis, hypertension, positive family history, co-arctation of the aorta, polycystic kidney disease, fibromuscular dysplasia and some connective tissue disorders.
Because of the associated systemic effects and the surgical requirements, patients with cerebral aneurysms present a unique challenge to the anesthesiologist. Successful anesthetic management of patients with cerebral aneurysms requires a thorough understanding of the natural history, pathophysiology, and surgical requirements of the procedures
Patients with poor clinical grades frequently present with multiorgan dysfunction. Cardiac, pulmonary, and renal systems are commonly affected by the high sympathetic discharge associated with SAH.
The goal of anesthetic plan for aneurysm surgery is to reduce the risk of aneurysm rupture by minimizing the transmural pressure (TMP) gradient across the aneurysm wall while simultaneously maintaining an adequate CPP. The aims are to titrate the depth of anesthesia and the blood pressure to match the surgical need, control ICP, minimise cerebral metabolic demands, prevent cerebral ischemia, ensure good operating conditions and allow rapid awakening.
The endovascular approach to treating cerebral aneurysms has become a superior option for selective patient groups and is widely used at present.
The leading causes of death and disability are, in descending order, vasospasm, the direct effects of the initial bleed, permanent ischemic effects of increased intracranial pressure, rebleeding, and surgical complications.