(BQ) Part 2 book “Fundamentals of neuroanesthesia - A physiologic approach to clinical practice” has contents: Neurosurgical critical care, ethical considerations and brain death, quality management and perioperative safety, neurosurgery in pediatrics, and other contents. | 15. ANESTHESIA FOR STEREOTACTIC RADIOSURGERY AND INTRAOPERATIVE MAGNETIC RESONANCE IMAGING Armagan Dagal and Arthur M. Lam A number of different systems are now available for stereotactic radiosurgery, and the anesthetic requirements for these procedures vary according to each patient as well as the systems used. This chapter briefly reviews the development and functional applications of stereotactic surgery and then discusses the anesthetic implications of this procedure. B AC KG R O U N D Two British scientists, Sir Victor Horsley (a pioneer neurosurgeon) and Robert Henry Clarke, described the stereotaxic apparatus and its applications for the first time in 1908 [1]. The name “stereotaxic” was adopted from the Greek words stereos, meaning “solid,” and taxis, meaning “arrangement.” (In the United States, the word “stereotactic” is preferred, combining the Greek word stereos with the Latin word tactis, the pluperfect passive form of the verb tangere meaning “to touch.”) Based on the Cartesian coordinate system, this device enabled them to map the brain in great detail, and they described procedures in which they were able to ablate intracranial targets using electrocoagulation. Three decades later, two American neurosurgeons, Ernest A. Spiegel and Henry T. Wycis, modified the design for use in stereotactic neurosurgical procedures in humans [2]. They created a molded frame for an individual patient’s head using a plaster cranial cap. They aligned their frame not just to the cranium but also to brain landmarks such as the calcified pineal gland and the foramen of Monroe by means of intraoperative pneumoencephalography, hence naming their device “stereoencephalotome.” By 1952, they had developed a stereotactic atlas of the human brain. In the 1950s, surgical incision of the extrapyramidal system to treat movement disorders (MDs) such as Parkinson’s disease (PD) started to emerge as a treatment option, and Russell Meyers, a neurosurgeon at the University of .
