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Perioperative Stroke

  • Neuroanesthesia (M Smith, Section Editor)
  • Published:
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Abstract

Purpose of Review

The significance of stroke in the noncardiac, nonneurologic, and nonvascular perioperative setting has been routinely underestimated. A complex interplay of multiple perioperative, patient, and surgical factors is involved in the pathogenesis of perioperative stroke. Multiple risk reduction strategies are required to decrease the incidence of this devastating complication.

Recent Findings

Recent evidence demonstrates that one in every 1000 patients undergoing low-risk surgery may develop perioperative stroke which can result in significant morbidity or mortality. The incidence of covert stroke is much higher. Further, it is now established that the majority of strokes do not occur during or immediately after surgery but at least 24 h later—thus emphasizing the need for active surveillance.

Summary

A high index of suspicion throughout the perioperative period, prompt diagnosis, and immediate management based on a multidisciplinary protocol is the key for successful outcome. In this article, we review recent evidence pertaining to this topic. We also suggest a model clinical care pathway for institutional management of perioperative stroke that could form the basis of multidisciplinary care.

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Authors and Affiliations

  1. Department of Anesthesiology, University of Michigan Health System, 1500 East Medical Center Drive, 1H247, Ann Arbor, MI, 48109, USA

    Raja V. Lakshmanan, Baskar Rajala & Laurel E. Moore

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  1. Raja V. Lakshmanan
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  2. Baskar Rajala
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  3. Laurel E. Moore
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Correspondence to Laurel E. Moore.

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Raja V. Lakshmanan, Baskar Rajala, and Laurel E. Moore declare that they have no conflict of interest.

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This article is part of the Topical Collection on Neuroanesthesia.

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Lakshmanan, R.V., Rajala, B. & Moore, L.E. Perioperative Stroke. Curr Anesthesiol Rep 6, 202–213 (2016). https://doi.org/10.1007/s40140-016-0167-4

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