<![CDATA[Neurosurgical emergencies demand rapid and coordinated anesthetic management to prevent secondary neurological injury and improve patient outcomes. Anesthesiologists play a critical role not only in facilitating surgical intervention but also in maintaining cerebral perfusion pressure (CPP), controlling intracranial pressure (ICP), and safeguarding neural function during periods of physiological instability. This review synthesizes current guidelines regarding anesthetic selection, hemodynamic targets, and specific neuroprotective strategies. Furthermore, optimal anesthetic management for acute ischemic stroke is re-evaluated based on recent research suggesting that conscious sedation may offer superior functional outcomes in minor anterior circulation strokes, whereas general anesthesia remains non-inferior for posterior circulation strokes. The review also highlights critical physiologic targets, emphasizing the strict avoidance of hypotension and the judicious use of moderate hypocapnia. By integrating these emerging evidence-based protocols, anesthesiologists can optimize management in neurosurgical emergencies settings, thereby improving patients’ functional recovery and survival rates.]]>
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