Neurosurgical Anesthesia

Neurosurgical Anesthesia

The division of neurosurgical anesthesiology at NYU Langone Medical Center is an active service performing over 2,200 anesthetics annually. There are currently nine full time anesthesiology attendings associated with this division,. Members of this group provide anesthesia in the operating room, neuroradiology, and in MRI and CT suites. Recently a hybrid operating room was opened at Tisch Hospital so neurosurgical and neuro-radiological procedures can be performed on the same patient in the same location.

Clinical Case Mix

Every type of neurosurgical procedure is performed here at NYU Langone Medical Center. Craniotomies are performed for patients with tumors, vascular lesions, and functional neurological diseases such as epilepsy and movement disorders. NYU Langone Medical Center is an internationally recognized center of excellence for neurosurgery. About 90% of patients undergoing craniotomies under general anesthesia require neurophysiologic monitoring. For these procedures, we use intravenous anesthetics and analgesics only (TIVA). Neurosurgical patients often require a neurological exam at the end of a procedure. To meet this challenge, we monitor anesthetic depth using a Bispectral Index (BIS) monitor on most of our patients.

The epilepsy center at NYU Langone Medical Center refers many patients for surgery. While many of these cases are performed under general anesthesia, some are performed as "awake craniotomies", particularly when cerebral areas associated with language are involved.

NYU Langone Medical Center has long been a center for management of patients with cerebral vascular lesions. We provide anesthesia for patients with arteriovenous malformations, cerebral aneurysms, and, occasionally, carotid artery stenosis.

Spine surgery represents another area of excellence. Besides the routine spinal discectomies, we also provide anesthesia for patients having more complicated spinal procedures. About 50% of these procedures involve intraoperative electrophysiologic monitoring. Patients with cervical spine disease require special techniques for airway management, including fiberoptic scope and intubating LMA.

The NYU invasive neuroradiology department is busier than ever. Our neuro-radiologists perform procedures primarily for intracerebral or spinal vascular lesions. These include arteriovenous malformations and aneurysms. In addition, NYU Langone Medical Center is now a stroke center so patients with strokes can receive thrombolytic therapy to open the occluded cerebral vessels.

In summary, the division of neurosurgical anesthesiology provides state of the art anesthesia care for a wide variety of neurosurgical and neuroradiological procedures.

Faculty

  • John Ard, MD
  • Marc Bloom, MD, PhD
  • Tessa Kate Huncke, MD
  • Carolyn Kim, MD
  • Sunmi Kim, MD
  • Jerome Lax, MD
  • Mitchell Lee, MD
  • Aleksey Pryadko, MD
  • Ganesh Rambissoon, MD