Perioperative management of intracranial-extracranial communicating tumors with multidisciplinary combined surgery: a case series.

Background: To analyze the clinical characteristics of patients with complex skull base lesions involving both intracranial and extracranial regions and summarize the anesthetic management experience for combined neurosurgical and oral-maxillofacial procedures under a single anesthesia session.

Case Presentation: Medical records of patients who underwent combined neurosurgical and oral-maxillofacial surgery at Beijing Tiantan Hospital, Capital Medical University, between April 1, 2020, and April 1, 2025, were retrospectively reviewed. Clinical data, multidisciplinary treatment, anesthetic management, and outcomes were analyzed.

Emergency Conversion to General Anesthesia During Endovascular Therapy and Stroke Outcomes: A Retrospective Matched Study.

Background: In endovascular treatment (EVT) for ischemic stroke, conversion from non-general anesthesia (non-GA) to general anesthesia (GA) may be necessary. This study aims to evaluate the effects of intra-EVT emergency GA conversion on patient outcomes and to identify potential risk factors for such conversions.

Methods: A retrospective cohort study was conducted on ischemic stroke patients who underwent EVT without GA at a tertiary hospital in China.

Transcutaneous auricular vagus nerve stimulation prevents postoperative delirium in elderly patients (VNSTAR): protocol for a multicentre, randomised controlled trial.

Introduction: Postoperative delirium (POD) is a common complication in elderly patients and is closely associated with delayed recovery, prolonged hospital stays, increased mortality rates and increased medical expenses. Vagus nerve stimulation, a novel technique in the field of neuroscience, has demonstrated remarkable therapeutic potential in improving neurocognitive disorders. However, its applicability in ameliorating neurocognitive dysfunctions that arise during the perioperative period remains unclear.

Opioid-free anaesthesia and postoperative quality of recovery in patients undergoing supratentorial tumour resection: protocol for a randomised controlled trial.

Introduction: Opioids play a pivotal role in being capable of effectively blocking the pain and stress responses triggered by procedures such as surgery and intubation. However, it should not be overlooked that opioids have numerous side effects, such as respiratory depression, postoperative nausea and vomiting. These effects can raise intracranial pressure, posing a life-threatening risk in neurosurgical patients.

Scalp block improves electrophysiological stability and patient cooperation during deep brain stimulation surgery.

Deep Brain Stimulation (DBS) is a critical intervention for various neurological disorders. While effective, the traditional local infiltration anesthesia used in DBS surgeries often hinders electrophysiological recording quality and patient cooperativeness. The research aims to evaluate the impact of local infiltration versus scalp block anesthetic methods on electrophysiological signal quality and patient cooperativeness during DBS surgeries.

Effect of esketamine on postoperative sleep disturbance in patients undergoing spinal surgery: a study protocol for a randomised, double-blinded, placebo-controlled clinical trial.

Introduction: Postoperative sleep disturbance (PSD) is a common complication after spinal surgery that can be related to postsurgical pain, perioperative anxiety and depression. Recent studies have shown that esketamine may improve sleep disturbance after surgery; however, it remains unclear whether intraoperative infusion of esketamine can improve the postoperative sleep quality of patients undergoing spinal surgery.

Methods And Analysis: This is a protocol for a randomised, double-blinded, placebo-controlled clinical trial to evaluate the effect of esketamine on PSD in patients undergoing spinal surgery.

Safety and Efficacy of Neuroprotective Agents as Adjunctive Therapies for Reperfusion in the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

There is still no clear evidence of the efficacy of the application of neuroprotective agents (NPAs) for acute ischemic stroke (AIS) patients receiving reperfusion therapies. This meta-analysis aimed to determine the effects of NPAs versus placebo on functional and safety outcomes as an adjunctive treatment to intravenous thrombolysis (IVT) or endovascular therapy (EVT) in AIS patients. The primary outcome was neurological functional independence, as evaluated by the proportion of patients whose modified Rankin Scale scores were 0 to 2 at 90 days after treatment.

Oxygenation targets for endovascular therapy in acute ischemic stroke patients (Oxy-TARGET): protocol for a single-centre, open-label randomised controlled trial.

Introduction: Preclinical studies have shown that oxygen therapy can improve ischaemic brain tissue oxygen tension, reduce reperfusion injury after revascularisation, promote neuroregeneration and inhibit inflammatory responses potentially exerting a beneficial effect after endovascular treatment (EVT) in patients with acute ischaemic stroke (AIS). However, the optimal fraction of inspired oxygen (FiO) during EVT under general anaesthesia is currently unknown. Therefore, we are conducting a randomised controlled trial (RCT) to evaluate the impact of high-concentration oxygen vs low-concentration normobaric oxygen on early neurological function after EVT.

Vitamin D can mitigate sepsis-associated neurodegeneration by inhibiting exogenous histone-induced pyroptosis and ferroptosis: Implications for brain protection and cognitive preservation.

Background: Sepsis-induced neurodegeneration and cognitive dysfunction remain critical challenges worldwide. Vitamin D was reported to reduce neuronal injury and neurotoxicity and its deficiency was associated with neurocognitive disorders. This study investigates the mechanisms by which vitamin D exerts neuroprotective potential against damage-associated molecular patterns (DAMPs), specifically extracellular histones, in sepsis-related brain dysfunction.

Associations of arterial oxygen partial pressure with all‑cause mortality in critically ill ischemic stroke patients: a retrospective cohort study from MIMIC IV 2.2.

Background: As a supportive treatment, the effectiveness of oxygen therapy in ischemic stroke (IS) patients remains unclear. This study aimed to evaluate the relationships between arterial partial pressure of oxygen (PaO) and both consciousness at discharge and all-cause mortality risk in ICU IS patients.

Methods: Blood gas measurements for all patients diagnosed with IS were extracted from the MIMIC-IV database.

Development and Validation of a Two-step Model to Predict Outcomes After Endovascular Treatment for Patients With Acute Ischemic Stroke.

Background: Physicians and patients are eager to know likely functional outcomes at different stages of treatment after acute ischemic stroke (AIS). The aim of this study was to develop and validate a 2-step model to assess prognosis at different time points (pre- and posttreatment) in patients with AIS having endovascular thrombectomy (EVT).

Methods: The prediction model was developed using a prospective nationwide Chinese registry (ANGEL-ACT).

Anaesthesia modality on endovascular therapy outcomes in patients with large infarcts: a post hoc analysis of the ANGEL-ASPECT trial.

Objectives: Endovascular therapy (EVT) now penetrates the once obscure realm of large infarct core volume acute ischaemic stroke (LICV-AIS). This research aimed to investigate the potential correlation between different anaesthetic approaches and post-EVT outcomes in LICV-AIS patients.

Methods: Between October 2020 and May 2022, the China ANGEL-Alberta Stroke Programme Early CT Score (ASPECT) trial studied patients with LICV-AIS, randomly assigning them to the best medical management (BMM) or BMM with EVT.

Effect of desflurane anesthesia on flash visual evoked potential monitoring in patients undergoing spine surgery: study protocol for a randomized controlled trial.

Background: Flash visual evoked potentials (FVEPs) are a reliable method for protecting visual function during spine surgery in prone position. However, the popularization and application of FVEPs remain limited due to the unclear influence of various anesthetics on FVEPs. Exploring the effects of anesthetic drugs on FVEP and establishing appropriate anesthesia maintenance methods are particularly important for promoting and applying FVEP.

Dynamic Cortical Connectivity During Propofol Sedation in Glioma Patients.

Background: The behavioral manifestations and neurophysiological responses to sedation can assist in understanding brain function after neurological damage, and can be described by cortical functional connectivity. Glioma patients may experience neurological deficits that are not clinically detectable before sedation. We hypothesized that patients with gliomas exhibit distinct cortical connectivity patterns compared to non-neurosurgical patients during sedation.

Intensive Versus Standard Blood Pressure Management after Endovascular Therapy for Acute Ischemic Stroke: A Systematic Review and Meta-analysis.

Prospective clinical studies on blood pressure (BP) management targets after endovascular therapy (EVT) for acute ischemic stroke (AIS) have recently been published. Our objective was to assess the impact on clinical outcomes of BP management guided by established systolic BP (SBP) targets within the first 24 hours after successful EVT. Four randomized controlled trials (RCTs) including 1556 participants across 5 SBP target settings identified from 5 databases up to September 6, 2023 were included in this systematic review and meta-analysis.

Anesthesia on Clinical Outcomes in an Extended Time Window During Endovascular Stroke Therapy: Exploratory Analysis of the ANGEL-ACT Registry.

Objective: Data on the impact of different anesthesia methods on clinical outcomes in patients with acute ischemic stroke undergoing endovascular therapy (EVT) in extended windows are limited. This study compared clinical outcomes in patients with stroke having general anesthesia (GA), conscious sedation (CS), or local anesthesia (LA) during EVT in extended (>6 h) time windows.

Methods: We conducted an exploratory analysis of data from the ANGEL-ACT registry.

Red blood cell transfusion in neurocritical patients: a systematic review and meta-analysis.

Background: Anemia can lead to secondary brain damage by reducing arterial oxygen content and brain oxygen supply. Patients with acute brain injury have impaired self-regulation. Brain hypoxia may also occur even in mild anemia.

Effect of esketamine combined with pregabalin on acute postsurgical pain in patients who underwent resection of spinal neoplasms: a randomized controlled trial.

Moderate-to-severe acute postsurgical pain (APSP) can prolong the recovery and worsen the prognosis of patients who undergo spinal surgery. Esketamine and pregabalin may resolve APSP without causing hyperpathia or respiratory depression after surgery. However, there are other risks, such as dissociative symptoms.

General anesthesia versus nongeneral anesthesia during endovascular therapy for acute ischemic stroke: A systematic review and meta-analysis.

Objective: This study compares the safety and efficacy of general anesthesia (GA) and nongeneral anesthesia (non-GA) on functional outcomes in patients receiving endovascular therapy for ischemic stroke.

Methods: All available studies on the anesthetic management of patients with acute ischemic stroke in PubMed, the Cochrane Central Register of Controlled Trials, and Embase were included. We also compared the clinical outcomes in the studies with subgroup analyses of the occlusion site (anterior vs.

Effect of intraoperative muscle relaxation reversal on the success rate of motor evoked potential recording in patients undergoing spinal surgery: a randomized controlled trial.

Background: Partial neuromuscular blockade (NMB) has been applied for some surgeries to reduce bleeding and prevent patient movement for spinal surgery. Sugammadex selectively binds to rocuronium in the plasma and consequently lowers the rocuronium concentration at the neuromuscular junction. In this study, we aimed to observe whether the success rate of transcranial motor-evoked potential (TceMEP) can be increased by sugammadex compared with partial NMB during spinal surgery.

Association of Admission Glucose and Outcomes After Endovascular Treatment for Acute Stroke: Data From the ANGEL-ACT Registry.

Background: The association between admission glucose levels and clinical outcomes after stroke has not been effectively elucidated. This study assessed the association among admission glucose levels, admission hyperglycemia, diabetes mellitus, and 90-day neurological outcomes in patients with acute ischemic stroke undergoing endovascular therapy.

Methods: The ANGEL-ACT registry enrolled adults with acute ischemic stroke undergoing endovascular therapy between 2017 and 2019 in China and patients with available admission glucose data were included.

A Global Review of the Perioperative Care of Patients With Aneurysmal Subarachnoid Hemorrhage Undergoing Microsurgical Repair of Ruptured Intracerebral Aneurysm.

Introduction: To describe the perioperative care of patients with aneurysmal subarachnoid hemorrhage (aSAH) who undergo microsurgical repair of a ruptured intracerebral aneurysm.

Methods: An English language survey examined 138 areas of the perioperative care of patients with aSAH. Reported practices were categorized as those reported by <20%, 21% to 40%, 41% to 60%, 61% to 80%, and 81% to 100% of participating hospitals.

Hierarchical fluctuation shapes a dynamic flow linked to states of consciousness.

Consciousness arises from the spatiotemporal neural dynamics, however, its relationship with neural flexibility and regional specialization remains elusive. We identified a consciousness-related signature marked by shifting spontaneous fluctuations along a unimodal-transmodal cortical axis. This simple signature is sensitive to altered states of consciousness in single individuals, exhibiting abnormal elevation under psychedelics and in psychosis.

Cerebral tissue oximeter suitable for real-time regional oxygen saturation monitoring in multiple clinical settings.

Maintenance of adequate blood perfusion and oxygen delivery is essential for cerebral metabolism. Cerebral oximeters based on near-infrared spectroscopy (NIRS) have been used for noninvasive, continuous, real-time monitoring of cerebral oxygen saturation and management of cerebral oxygen adequacy perioperatively and intraoperatively in various clinical situations, such as cardiac surgery, anesthesia, and cerebral auto-regulation. In this study, a portable and modular cerebral tissue oximeter (BRS-1) was designed for real-time detection of regional oxygen saturation over the brain, finger, or other targeted body tissues, as well as for wireless cerebral oxygenation monitoring.