INTRACRANIAL SURGICAL PHYSIOLOGY

1
INTRACRANIAL SURGICAL PHYSIOLOGY
Glucose 60 mg/min which is 25 of total body
consumption Oxygen 45ml/min which is 20 o of
total body consumption Oxygen uptake depends
upon 1 cerebral blood flow 2 oxygen content
of blood 3pH 4body temperature
OXYGEN 1mole GLUCOSE 38 MOLES OF ATP
In hypoxia 1 mole of glucose gives 2 molecules
of ATP plus Lactic acid.
2
ENERGY(ATP)
1Ionic gradient across the membrane 2neurotransm
ission/neurotransmitters
Synthesis,release,uptake and destruction of
neurotransmitters. 3preservation of cellular
structure in nervous system which includes
complex process of lipid metabolism which
includes process of myelinization of
neurons. 4synthesis of proteins for information
storage 5CSF formation process Total brain
ischemia leads to loss of consciousness in 15
seconds Irreversible damage in 2 minutes.
3
Energy Crisis of the Brain
1 Hypoxia/ischemia 2 Hypoglycemia
Effect is in the form of change in EEG
depletion of tyrosine hydroxylase required for
synthesis of noradrenaline/dopamine
Fall in acetylcholine Decrease in brain
Lipids such as phospatidylinositol Efflux
of potassium and influx of calcium CLINICAL
EFFECT OF INTERRUPTION LEADS\ TO ALTERATION IN
PERSONALITY,JUDGMENT, MEMORY,IMPAIRED TOLERANCE
OF DRUGS AND ALCOHOL AND PROFOUND COMA
4
(No Transcript)
5
(No Transcript)
6
(No Transcript)
7
CELL DAMAGE DUE TO ENERGY CRISIS 1Purkinje cell
in cerebellum 23-5-6 layer in cerbrum 3somersect
or of Ammons horn in hippocampus 4boundary zones
Venous(jugular) Po2 30 unconsciousness
15 EEG
10 cell death

8
0.3-0.5ml\mn 150 normal vol
9
Hypercapnia Hypoxia
10
(No Transcript)