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Neuroanesthesiology Division

Neurosurgery

About Our Neuroanesthesiology Division

UR Medicine’s Strong Memorial Hospital performs over two thousand neurosurgical procedures each year. It is the area’s only comprehensive stroke center and has the area’s only dedicated NeuroMedicine Intensive Care Unit. Patients undergoing neurosurgical procedures present a unique challenge for anesthesiologists, requiring a complete understanding of the physiology and pharmacology of the brain, special considerations in neurosurgical patients (including monitoring and positioning), and safe anesthetic management for various neurologic diseases and injuries.

Our Neuroanesthesiology Division provides care for these patients as they undergo a wide variety of complex and routine intracranial and spine surgeries. We work closely with URMC neurosurgeons, intensivists, neurologists, and radiologists. We are a critical piece of the interventional stroke response; Strong’s stroke quality improvement initiative has won local and regional awards for excellence. Our division has also created a team to coordinate care of patients who are to undergo “awake” craniotomies for the surgical treatment of intractable epileptic seizures and tumors of eloquent cortex. Our footprint continued to expand as we redesign our operating rooms to facilitate more neurointerventional procedures.

Training the next generation of anesthesiologists is an important part of our activities. Residents are required to complete two neuroanesthesia rotations. The first is an 8-week rotation that starts with two weeks on the acute stroke service followed by two weeks with the neurophysiology team. This is then followed by four weeks in the operating room providing neurosurgical anesthesia. The second neuroanesthesia rotation focuses on more complex procedures and the management of patients receiving neurointerventional care for stroke and vascular procedures. During both of these rotations, residents provide anesthetic care for a wide array of neurosurgical cases, including functional neurosurgery with deep brain stimulation, complex spine surgery, minimally invasive spine surgery, carotid endarterectomies, endovascular and open aneurysm treatment, and craniotomies. As we are the region’s trauma center, residents also gain experience in the anesthetic management of head trauma and in airway management of cervical spine injuries. Residents attend Neuroeducation Day, a formal day-long course taught by our faculty and representatives from neurosurgery and neuromonitoring. Residents also learn through hands-on operating room experience and formal structured didactics. This approach provides a comprehensive experience allowing the graduate to provide quality anesthetic care to a wide variety of neurosurgical patients.

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