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Abstract T he perioperative course of patients undergoing intracranial tumors may be complicated by the occurrence of emergence hypertension (Basali,2000). Intraoperative, acute hypertensive episodes occur during brain manipulation, but more often are produced by events such as epinephrine containing local anesthetic administration, head pin-holder application, and periosteal dissection and are more common during emergence and in early postoperative period (Horwitz.,1986). Hypertension may be associated with a number of adverse pathophysiological consequences. When cerebral autoregulation is disturbed or its limits are exceeded blood flow passively increases with blood pressure. This in turn can increase intracranial pressure (ICP) or causes breakdown of the blood brain barrier with resultant transudation of intravascular fluid. Bleeding and signs of encephalopathy may ensue (Thomas.,2005). |