[Cerebral Emergency - Important Anesthesiological Aspects]

The anesthesiological management of cerebral emergency represents a great challenge for action under pressure and under time pressure and requires smooth interprofessional cooperation. The exact knowledge of the pathophysiological and pharmacological relationships is the basis for rapid identification of therapeutic influences and possible disturbing factors. In the acute situation, paCO₂ and MAP are the central determinants for the anesthetist to ensure cerebral perfusion and the resulting cerebral oxygenation. Especially in patients with SHT, a difficult airway must always be expected. Knowledge of the appropriate steps and the necessary equipment must be available. In patients under anticoagulant therapy, written instructions for suspending this therapy are extremely helpful. Interventional thrombectomy is a new emergency situation for the anesthetist. The door-to-needle time has to be kept as short as possible by defined treatment paths and rapid goal-oriented work. Every emergency also creates a stressful reaction in those treating the patient - in a sense, the cerebral emergency "in us". This has a decisive influence on the perception and action of the individual and the entire team.