Early brain injury and subarachnoid hemorrhage: where are we at present?

The current era has adopted many new innovations in nearly every aspect of management of subarachnoid hemorrhage [SAH]; however, the neurological outcome has still not changed significantly. These major therapeutic advances mainly addressed the two most important sequels of the SAH-vasospasm and re-bleed. Thus, there is a possibility of some different pathophysiological mechanism that would be responsible for causing poor outcome in these patients. In this article, we have tried to compile the current role of this different yet potentially treatable pathophysiological mechanism in post-SAH patients. The main pathophysiological mechanism for the development of early brain injury [EBI] is the apoptotic pathways. The macro-mechanism includes increased intracranial pressure, disruption of the blood-brain barrier, and finally global ischemia. Most of the treatment strategies are still in the experimental phase. Although the role of EBI following SAH is now well established, the treatment modalities for human patients are yet to be testified

Neuroanesthetic considerations for emergent extracranial surgeries: What to know?

Neuroanaesthetic considerations in non neurosurgical cases are utmost important for the optimal management of such cases. These considerations become even more challenging in patients undergoing emergency surgeries. We have highlighted the neuroanesthetic considerations for three broad categories. The two most important considerations in this type of surgery will be the avoidance of secondary brain insult and maintenance of optimal cerebral perfusion pressure