MetroHealthAnesthesiaNeuroanesthesiology, MHMC
Case Western Reserve University, MetroHealth Campus
Anesthesiology Resident Education/Training Objectives

Division of Neuroanesthesiology
Clinical Training CA-1 and CA-2
Advanced Clinical Training CA-3

The Neuroanesthesia clinical rotation at MetroHealth Medical Center offers the resident experiences in a wide range of neurosurgical cases including: extra and intracranial (aneurysms and arteriovenous malformations) vascular surgery, benign and malignant intracranial tumors, craniobasal and craniofacial surgery, transsphenoidal pituitary surgery, posterior fossa craniotomies, head trauma, pediatric neurosurgery, stereotactic and brain biopsy procedures and spinal surgery involving Evoked Potential Monitoring.

The objectives for the Clinical Training for CA-1 and CA-2 include:

  1. Knowledge of cerebal, cerebrovascular and spinal cord physiology including blood flow dynamics, metabolism and causes/consequences of altered physiology.
  2. Becoming familiar with the physiopathlology of intracranial pressure and cerebral edema, causes and treatment.
  3. The effect of coexisting disease on cerebral pathophysiology.
  4. Knowledge of cerebrovascular pharmacology of anesthetic agents and other drugs used on the neurosurgical patient; effects on physiology and metabolism.
  1. Being familiar with various neurosurgical techniques and approaches of neurosurgery including sitting craniotomies, Evoked Potential Monitoring and electrostimulation implants.
  2. Preoperative, intraoperative and postoperative care of the routine and emergency patients with neurological problems.
  3. Patient evaluation, induction and maintenance of anesthesia, invasive and noninvasive monitoring.
  4. Neuroanesthesia techniques such as induced hypothermia, reduction of increased intracranial pressure and the use of techniques that might attenuate sequelae of focal ischemia.
  5. Satisfactory completion of neuroanesthesia clinical rotation exam.

The objectives of the Advanced Clinical Training for the CA-3 include:

  1. Review of the basic clinical objectives for CA-1 and CA-2.
  2. Focusing on preoperative evaluation of the neurosurgical patient and clinical decision making.
  3. Impact of coexisting disease on clinical decision making for the neurosurgical patient involving further preoperative testing, intraoperative monitors and postoperative pain management.
  4. Evaluation of clinical involving choice of induction agent, neuromuscular blocking agents, maintenance anesthesia and postoperative planning.
  5. Satisfactory completion of neuroanesthesia mock oral exam by staff attending anesthesiologist.

Send Comments to Greg Gordon MD, [email protected]
Department of Anesthesiology
The MetroHealth System
2500 MetroHealth Drive
Cleveland, Ohio 44109-1998
Phone: (216) 778-4801
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