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Neuroanaesthesia in the elderly 

Neuroanaesthesia in the elderly
Chapter:
Neuroanaesthesia in the elderly
Author(s):

Bernard Graf

and Chris Dodds

DOI:
10.1093/med/9780199604999.003.0022
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date: 20 August 2019

This chapter discusses the important factors to be understood when caring for elderly neurosurgical patients. It summarizes the changes in the elderly neurological system with ageing and the difficulties in their assessment. There follows a review of the risks and benefits of manoeuvres used in younger patients to maintain cerebral perfusion pressure. Anaesthesia for craniotomy, tumour excision, or intracranial bleeding is then covered, including monitoring, induction, positioning, maintenance, and recovery. Traumatic brain injury is reviewed from initial care in the emergency department to definitive care. Management of chronic subdural haematoma as one of the commonest neurosurgical presentations in the elderly is reviewed followed by a discussion on surgery on the spine. The care needed to maintain spinal perfusion is emphasized as is the risks associated with positioning, especially prone. Finally the chapter comments on the prolonged nature of recovery in the elderly from any form of major injury and surgery.

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