Understanding cerebral physiology is fundamental to neuroanesthesia. Every decision we make in the operating room, from adjusting ventilation and blood pressure to choosing anesthetic agents or positioning the patient, can influence cerebral blood flow, intracranial pressure, and ultimately brain perfusion. The challenge is not simply knowing these concepts, but understanding how they interact in real clinical situations. 

This educational session was designed to move beyond memorizing physiologic values by placing residents in a realistic intraoperative scenario. Through a progressive case, participants are asked to think through the physiologic consequences of common anesthetic interventions and apply core principles to the management of patients undergoing intracranial surgery. 

By combining foundational physiology with clinical decision-making, the session aims to help anesthesia residents develop a practical framework for approaching neurosurgical cases and making thoughtful, physiology-based anesthetic decisions.