Anesthetic Considerations for Endo-Vascular Management of Intracranial Aneurysms

Abstract

This essay aims at reviewing current medical literature about anesthesia for endovascular management of intracranial aneurysms as regards the anatomy of circle of willis, different types of aneurysms, common sites of aneurysms and physiology of cerebral blood flow and regulation of it, effect of different anesthetic agents on CBF. Intra cranial aneurysms are acquired lesions responsible for about 80% of non-traumatic sub arachnoid hemorrhage. Intra cranial aneurysms affect 5-10% of people. And rare in children. There are many risk factors like: age, medical history, positive family history of the diseases, aneurysm site, size, morphology. There are many heritable diseases associated with intracranial aneurysm like: autosomal dominant poly cystic kidney. There many genes location on the chromosomes have to be linked to familial intracranial aneurysm and present in many populations. The clinical presentation of unruptured cerebral aneurysms include: headache, ischemic cerebrovascular events and cranial nerves affection. While subarachnoid hemorrhage has typical symptoms like: thunderclap headache, meningism and altered mentality. Less frequent symptoms like: seizures, mild headache, ECG changes.