Perioperative management of a patient with subarachnoid hemorrhage complicated with descending aortic dissection

: A 62-year-old man with descending aortic dissection received general anesthesia for clipping of aneurysm of the cerebral artery. We chose a surgical operation for the aneurysm of the cerebral artery, and conservative therapy for the dissection of the aorta. We gave balanced anesthesia with blood pressure control using calcium channel blocker. Anesthesia was induced with propofol, fentanyl, and vecuronium, and maintained with isoflurane, fentanyl, nitrous oxide and oxygen. Transesophageal echocardiography was useful for checking dissection of the aorta. Perioperative course was uneventful.