الفهرس 
NERVE SUPPLY OF HEAD AND NECKOnly 14 pages are availabe for public view
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Abstract
While the debate continues over the advantages of regional anesthesia versus general anesthesia for many forms of surgery, there is an increasing number of indications in intracranial surgery for the patient to be awake during some or all of the operation .
This may be a hard task for the Neuroanesthetist who is inexperienced in the technique of awake craniotomy. However, with a sound anatomical knowledge of the nerve blocks and the knowledge to anticipate certain predictable intraoperative events, this can be an extremely rewarding procedure for the Neuroanesthetist, whilst offering the patient the best possible outcome from the surgery.
The traditional indication for awake craniotomy has been epilepsy surgery and, in particular, temporal lobectomy where the excision occasionally encroaches on the eloquent cortex (motor and speech areas). Tumour or arteriovenous malformation surgery where the lesion abuts or invades the speech, motor, sensory or visual cortex may also involve intraoperative functional testing or cortical mapping, requiring the patient to be awake. Occasionally, avoidance of general anesthesia is advisable for medical reasons and confidence with the awake craniotomy technique allows local anesthesia with sedation to be considered as an option.
Anesthetic care is probably the most unique aspect of awake craniotomy. The primary goal of the anesthetist is to make the operation safe and effective while reducing the psychophysical distress of the patient