This issue of Anesthesiology Clinics provides essential updates in neurosurgical anesthesia. Topics include anesthesia for endovascular neurosurgery; interventional neuroradiology; neuroimaging; anesthetic management of patients with acute stroke; perioperative management of pediatric patients; anesthetic neurotoxicity; airway management in neuroanesthesiology; anesthetic considerations for awake craniotomy for epilepsy; perioperative uses of trans cranial perfusion monitoring; monitoring and introaoperative management of elevated ICP and decompressive craniectomy; electrophysiologic monitoring in neurosurgery; traumatic brain injury; perioperative pain management in the neurosurgical patient; controversies in neurosciences critical care; sleep and mechanisms of anesthesia; and impacts on outcome after neuroanesthesia.