As a recognized subspecialty of anesthesiology, it includes the anesthesiological care of patients undergoing brain, spinal cord and spine surgery and requires extensive specialized knowledge of physiology and pathology of the central nervous system with the particularity that surgeon and anesthesiologist share the same target organ. At our clinic, approximately 1500 patients of all ages, from immature premature infants to the elderly, receive anesthesiological care in neurosurgery every year. The treatment spectrum includes procedures for the removal of brain and spinal cord tumors, vascular malformations and complex spinal surgery, as well as the care of patients after craniocerebral and spinal injuries. Demographic change with an increase in geriatric patients and their age-related concomitant diseases, the constant development of new surgical methods as well as special positioning techniques require great flexibility in anesthesiological care. In addition to all common monitoring procedures, neurophysiological monitoring is part of the standard and is performed in close cooperation with neurosurgical colleagues.

During posterior fossa procedures in the sitting position, precordial Doppler and now transesophageal echocardiography (TEE) are standard for detecting air emboli.

In a special area of neurosurgery, "Functional Stereotaxy", patients with movement disorders in neurodegenerative diseases such as Parkinson's disease or dystonia receive anesthesiological care. The long duration of the procedure requires a great willingness to cooperate on the part of the patients. Intensive individual care of the patients is required, since in deep brain stimulation (THS) the probes are inserted into the target region while the patient is awake under local anesthesia in combination with mild analgesia.