Hemanshu Prabhakar - Problem Based Learning Discussions in Neuroanesthesia and Neurocritical Care

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The Authors of this book, dedicated to clinical practice ofNeuroanesthesia and Neurocritical Care, have adopted an innovative approach based on case scenario discussion. I am extremely pleased and honored to contribute to these forewords to present the result of a long-lasting effort in international networking aimed to fulfill educational need of our subspecialty. In time, I have met and had the opportunity to cooperate with several of the contributors of this book, and this makes it easy for me to witness their quality as scientists and clinicians.

The first notion of neuroanesthesiathe practice of anesthesia for brain or spinal surgerydates back to the late 1940s. Since then, this subspecialty has experienced significant improvements in terms of quality of delivered care, complexity of treated patients and performed procedures, and the number of treated cases. Specific education path are now available, and this is a substantial contribution to reach high level of quality in patients care along with personal experience and case load. This book provides a substantial contribution within these three important aspects to obtain better short- and long-term outcomes in patients undergoing neurosurgical procedures and to better define the competences necessary for an accredited subspecialty practice.

According to a contemporary approach, clinical workup should take into account principles of evidence-based medicine that are derived by clinical experience and research results. In everyday neuroanesthesia, it is important to achieve a dedicated clinical trainingthat begins in general anesthesiologyand a full understanding of the unique features of the neurosurgical or neurologically injured patients. Education in neuroanesthesia and neurocritical care should also include simulation training and research activity so that residents and fellows could learn specific tasks and build confidence with essential features in order to provide excellent ability. In clinical practice, neuroanesthesiology requires also nonprofessional competencies such as effective communication and interdisciplinary interactions among all the members of the clinical team. Specific knowledge and competences required make neuroanesthesia and neurocritical care a unique medical field.

This book entitledProblem Based Learning Discussions in Neuroanesthesia and Neurocritical Careedited by Hemanshu Prabhakar and colleagues includes four major chapters: neurosurgical procedures; neurological patients; neuroradiology procedures; and other procedures and specific circumstances such as pregnant or HIV patients with brain tumor, or geriatric patients with intraparenchymal bleed. The chapter on neurosurgical procedures is dedicated to clinical management of intracranial A-V malformation, brachial plexus injury, brain abscess, cerebellopontine angle tumor, subarachnoid hemorrhage, cervical spine injury, craniosynostosis, craniopharyngioma, acromegaly, craniovertebral junction anomaly, hydrocephalus, lumbar PIVD, Moyamoya disease, meningomyelocele, pituitary tumor-Cushings disease, posterior fossa tumor, supratentorial tumor, traumatic brain injuryEDH, traumatic brain injurySDH, motor strip gliomasawake craniotomy and trigeminal neuralgia. The chapter on neurological patients is dedicated to clinical management of scoliosis, GuillainBarre syndrome, myasthenia gravis, Parkinsons disease, stroke, and polyneuropathy. The chapter on neuroradiology procedures is dedicated to clinical management of embolization-aneurysm, carotid stenting, and vein of Galen malformation.

I strongly recommend for those that approach the clinical practice ofNeuroanesthesia and Neurocritical Careto go through this book in a systematic way and to use it to get ready for best clinical management. I also suggest this book to colleagues that are routinely involved in our discipline and to read the dedicated chapters when they will face one of the clinical scenario presented in this book; I am positive that it will be of great help in setting up a rationale workup for the daily practice.

There have been some great textbooks in neuroanesthesiology. However, as editors of this book, we felt the need to bring out a book that would interest the millennial generation of anesthesiologists and trainees. They are not just interested in clinical facts but would like to know how things work out and why it works out. It is important to communicate the foundations of neuroanesthesiology to the next generation effectively. Hence, the idea of writing a book in a case-based, problem-oriented format was born.