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Prevention and Management of Perioperative Neurological Complications in High-Risk Surgical Patients

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The High-risk Surgical Patient

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Abstract

The definition of risk in surgical patients is a controversial area.

The risk assessment depends on who is making the evaluation.

Neurological complications are an important source of morbidity that increase health resource consumption, impair quality of life, and threaten long-term patients survival.

There is no routine standard monitor of neural structures during surgery and anesthesia, except in some particular procedures.

Since neurological diseases have a lifetime prevalence of 6% in the general population, many patients with neurological diseases undergo surgery, and their perioperative management can be challenging.

The management of surgery in a patient with neurologic disease starts with an individualized assessment and treatment on the basis of the preoperative neurological condition.

The approach to these patients varies greatly depending on the type of neurologic disease, type of surgery, timing of the procedure (elective versus urgent surgery), and other clinical features of the patient.

Some of the most commonly encountered neurological conditions and perioperative complications can be summarized in the following: central nervous system vascular disease (including spinal cord ischemia); cognitive impairment (dementia, delirium, postoperative cognitive decline); other neurodegenerative diseases (e.g., Parkinson’s disease [PD]); epilepsy; multiple sclerosis; neuromuscular diseases (myasthenia gravis, dystrophies, polyneuropathies); headache; and visual loss.

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Authors and Affiliations

  1. S C Neurologia e Stroke Unit, Dipartimento di Neuroscienze, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Rachele Tortorella

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  1. Rachele Tortorella
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Correspondence to Rachele Tortorella .

Editor information

Editors and Affiliations

  1. Dipartimento di Emergenza Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Paolo Aseni

  2. Divisione di Cardiochirurgia, IRCCS Fondazione Policlinico San Matteo, Pavia, Pavia, Italy

    Antonino Massimiliano Grande

  3. Div. of Emerg. Surg., Abdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland

    Ari Leppäniemi

  4. Department of Pathophysiology and Transplantation, General Surgery and Trauma Team, University of Milano, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Osvaldo Chiara

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Tortorella, R. (2023). Prevention and Management of Perioperative Neurological Complications in High-Risk Surgical Patients. In: Aseni, P., Grande, A.M., Leppäniemi, A., Chiara, O. (eds) The High-risk Surgical Patient. Springer, Cham. https://doi.org/10.1007/978-3-031-17273-1_18

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  • DOI: https://doi.org/10.1007/978-3-031-17273-1_18

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-17272-4

  • Online ISBN: 978-3-031-17273-1

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