During week three,  the senior trainee will review the anesthetic management of the following procedures with an emphasis on choice of technique, monitoring, and approach to complications:

• Endovascular coiling of cerebral aneurysms and arteriovenous malformations
• Carotid stenting, trans-carotid revascularization
• Stroke management
• The trainee will also review the various monitoring modalities
  • Key aspects of raw and processed EEG and their clinical anesthetic applications and limitations
  • Clinical application and limitations of cerebral oximetry

Interventional neurosurgery:

Aneurysm coiling

• Fellows’ and Residents’ Audio Corner
  • Anesthesia for Neuro-Interventional Procedures (April 2016, Adrian Gelb, MD)      
• Quiz
  • Anesthesia for Neurointerventional Radiology
• PBLD
  • Aneurysm Coiling in a Parturient with SAH

Vasospasm

• Article
  • Balloon catheter technique for dilatation of constricted cerebral arteries after aneurysmal SAH (PMID: 6234754)

AVM embolization

• Quiz
  • Anesthesia for AV Malformations of the Brain
• Interactive case
  • Case Presentation: Endovascular Embolization of Intracranial Dural AV Fistula Benign?

 Carotid surgery

• Quiz
  • Carotid Disease & Neuromonitoring
• Fellows’ and Residents’ Audio Corner
  • Anesthetic considerations for carotid endarterectomy (August 2016, Dr. Arthur Lam)
• PBLD
  • Carotid Endarterectomy
• Article of the Month:
  • Long-term outcomes after stenting versus endarterectomy for treatment of symptomatic carotid stenosis: the International Carotid Stenting Study (ICSS) randomised trial (PMID: 25453443)

 Trans-carotid revascularization

• Article
  • Anesthetic Considerations for Transcarotid Artery Revascularization: Experience
    and Review of Forty Cases From a Single Medical Center (PMID: 33505816)

Stroke thrombectomy

• Quizzes
  • Cerebrovascular Atherosclerotic Disease
  • Stroke
  • Acute Stroke
• Fellows’ and Residents’ Audio Corner
  • ICU Management of Stroke Patients (February 2020, Dr. Ugan Reddy)
• JNA Podcast
  • Stroke Thrombectomy January 2016
  • General Anesthesia vs Conscious Sedation in Endovascular Thrombectomy for Stroke (January 2021, Dr. Vandse)

• Articles
  • General Anesthesia versus Conscious Sedation in Endovascular Thrombectomy for Stroke: A Meta-analysis of 4 Randomized Controlled Trials 2021 (PMID: 31567645)
  • Site of Occlusion May Influence Decision to Perform Thrombectomy Under General Anesthesia or Conscious Sedation 2021 (PMID: 31567854)
  • SNACC Consensus Statement: Anesthetic management of endovascular treatment for acute ischemic stroke during COVID19 Pandemic. 2020 (PMID: 32282614).
  • DEFUSE 3: Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. 2018 (PMID: 29364767)
  • DAWN: Thrombectomy 6 to 24 hours after Stroke with a Mismatch between Deficit and Infarct 2018 (PMID: 29129157)
  • Blood Pressure Thresholds and Neurologic Outcomes After Endovascular Therapy for Acute Ischemic Stroke An Analysis of Individual Patient Data From 3 Randomized Clinical Trials 2020 (PMID: 31985746)

Intraoperative EEG/processed EEG

• ICE-TAP: International Consortium for EEG training of Anesthesia Practitioners
• Quiz
  • EEG Monitoring in the Surgical Patient

• Fellows’ and Residents’ Audio Corner
  • Neuromonitoring for Intracranial Surgery (January 2018, Dr. Antoun Koht)
• Clinical Audio and Video Corner
  • EEG Trajectories During Anesthetic Emergence and Postoperative Delirium in the PACU (December 2018, Dr. Paul Garcia)
• Articles
  • Clinical Electroencephalography for Anesthesiologists: Part I: Background and Basic Signatures (PMID: 26275092)
  • Monitoring Depth of Anesthesia Utilizing a Combination of Electroencephalographic and Standard Measures Commentary

Cerebral oximetry 

• Quiz
  • Cerebral Oximetry

• Article of the month
  • The effects of systemic oxygenation on cerebral oxygen saturation and its relationship to mixed venous oxygen saturation: A prospective observational study comparison of the INVOS and ForeSight Elite cerebral oximeters. (PMID: 29484605)

Supplementary Reading (SNACC Bibliography Collection)

• Cerebral Ischemia articles (Neurophysiology → Cerebral Ischemia)
• AVM articles (Neurosurgery → Arteriovenous Malformation)
• Carotid endarterectomy articles (Neurosurgery → Carotid endarterectomy)
• EEG articles (Neuromonitoring → Electroencephalography) 
• Cerebral oximetry articles (Neuromonitoring → Cerebral oximetry)