By F. Signorelli
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Additional resources for Explicative Cases of Controversial Issues in Neurosurgery
Awake craniotomy. Minerva Anestesiol 2005; 71 (suppl 1, n 10): 183-5.  Sarang A, Dinsmore J. Anaesthesia for awake craniotomy-evolution of a technique that facilitates awake neurological testing. Br J Anaesth 2003; 90 (2): 161-5.  Sartorius CJ, Berger MS. Rapid termination of intraoperative stimulation-evoked seizures with application of cold Ringer’s lactate to the cortex. Technical note. J. Neurosurg 1998; 88: 349-51.  See JJ, Lew TW, Kwek TK, Chin KJ, Wong MF, Liew QY, Lim SH, Ho HS, Chan Y,Loke GP, Yeo VS.
This observation however, was based on his experiences as a neurosurgeon, where he treated patients that were referred some time after an intracranial bleeding or with longer lasting intracranial hypertension (hydrocephalus, tumors). Although Heymans showed in 1928 in animal research that there is an initial short-lasting tachycardia before the onset of bradycardia (Heymans 1928), it is only since the introduction of neuro-endoscopy, this has become of clinical relevance. Relying on the experience in relatively slow-evolving processes like a chronic subdural hematoma, hydrocephalus or cerebral tumors, many clinicians still consider bradycardia and hypertension as the first hemodynamic sign of hyperacute intracranial hypertension.
43] Suarez S, Ornaque I, Fábregas N, Valero R, Carrero E. Venous Air Embolism During Parkinson Surgery in Patients with Spontaneous Ventilation. Anesth Analg 2010; 110: 1138-45.  Verchére E, Grenier B, Abdelghani M, Siao D, Mussa S, Maurette P. Postoperative Pain Management After Supratentorial Craniotomy. J Neurosurg Anesthesiol 2002; 14 (2): 96-101.  Whittle IR, Midgley S, Georges H, et al. Patient perceptions of “awake” brain tumour surgery. Acta Neurochir 2005; 147: 275-7. 34 Explicative Cases of Controversial Issues in Neurosurgery  Zorzi F, Saltarini M, Bonassin P, Vecil M, De Angelis P, De Monte A.