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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2017 November;83(11):1178-89

DOI: 10.23736/S0375-9393.17.11976-0

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Perioperative stroke: incidence, etiologic factors, and prevention

Sher-Lu PAI , R. Doris WANG, Stephen ANISKEVICH

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA


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Stroke is a devastating complication that is difficult to diagnose in the perioperative setting because of the effects of anesthetic and analgesic agents. Lingering anesthesia effects hinder clinicians in identifying stroke symptoms, frequently resulting in a delay in diagnosis and treatment and in unfavorable outcomes. The authors performed a systematic search in PubMed and the Cochrane Central Register. The search aimed to identify studies published between January 1990 and December 2015 related to the common etiologic factors, incidence, risk factors, risk modifiers, and early management of perioperative stroke. Additional articles were identified after review of the references of selected articles. Although perioperative stroke is uncommon, the mortality rate is high. Patients have higher risk of perioperative stroke when undergoing cardiac and vascular operations than uncomplicated orthopedic and general procedures. Preoperative optimization for preexisting risk factors may reduce the rate of perioperative stroke. Prompt, early management can improve patient outcomes. Recognition of the incidence, risk factors, and causes of perioperative stroke may lead to prevention and proper management.


KEY WORDS: Brain ischemia - Cerebral hemorrhage - Operative surgical procedures - Risk factors - Stroke

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Publication History

Issue published online: November 17, 2017
Article first published online: September 13, 2017
Manuscript accepted: July 5, 2017
Manuscript revised: June 7, 2017
Manuscript received: January 30, 2017

Cite this article as

Pai SL, Wang RD, Aniskevich S. Perioperative stroke: incidence, etiologic factors, and prevention. Minerva Anestesiol 2017;83:1178-89. DOI: 10.23736/S0375-9393.17.11976-0

Corresponding author e-mail

pai.sherlu@mayo.edu