Abstract

E. A. M. FROST The increased use of the operating microscope combined with newer radiological techniques which have greatly improved early and precise diagnosis of intracranial disease mean that many more neurovascular procedures can be undertaken. As vascular disease is rarely restricted to the cerebral circulation, these patients frequently present with disease in many systems and are receiving a variety of drugs. Cerebral circulation and metabolism are responsive both to systemic physiological alterations and to all anaesthetic agents and techniques. The consequences to cerebral function may be catastrophic if spontaneous or induced changes are inappropriate to the brain's nutritional needs. To provide optimal protection to the brain during stress, the anaesthetist must appreciate both normal cerebral circulation and the consequences of cerebrovascular disease. ANATOMY

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