2. Airway Management in the Neurological and Neurosurgical Patient

  1. Edward M. Manno MD, FCCM, FAAN, FAHA
  1. Michael J. Souter MB, ChB, FRCA1,2

Published Online: 11 APR 2012

DOI: 10.1002/9781118297162.ch2

Emergency Management in Neurocritical Care

Emergency Management in Neurocritical Care

How to Cite

Souter, M. J. (2012) Airway Management in the Neurological and Neurosurgical Patient, in Emergency Management in Neurocritical Care (ed E. M. Manno), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118297162.ch2

Editor Information

  1. Neurological Intensive Care Unit Cleveland Clinic Cleveland, OH, USA

Author Information

  1. 1

    Department of Anesthesiology & Pain Medicine, Department of Neurological Surgery, University of Washington, USA

  2. 2

    Department of Anesthesiology, Harborview Medical Center, Seattle, WA, USA

Publication History

  1. Published Online: 11 APR 2012
  2. Published Print: 11 MAY 2012

Book Series:

  1. Neurology in Practice

Book Series Editors:

  1. Robert A. Gross and
  2. Jonathan W. Mink

Series Editor Information

  1. Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA

ISBN Information

Print ISBN: 9780470654736

Online ISBN: 9781118297162



  • airway management in neurological, neurosurgical patients;
  • focal neurological insults to brain;
  • adverse effects, on airway control centers;
  • obstructed airway alleviation, iatrogenic in airway;
  • induction drugs, hypnotics, analgesics, paralytics;
  • airway support, lifesaving if correctly used;
  • airway intubation, limited exposure of glottis;
  • Mallampati, in direct laryngoscopy, and LEMON score;
  • accessory devices, in “difficult airway kit”;
  • avoidance of aspiration, trial of extubation


The function of the airway is dependent on the neurological integration of many brainstem centers which can be easily disrupted by disease. Careful assessment of the airway is important to successful intervention. A number of relatively simple approaches are discussed, along with basic technique and available devices. An algorithmic approach to the difficult airway is outlined.