Perioperative stroke. Part I: General surgery, carotid artery disease, and carotid endarterectomy.

Content Provider	Semantic Scholar
Author	Wong, David Sai Hung
Copyright Year	1991
Abstract	Although stroke, defined as a focal neurological deficit lasting more than 24 hr, is uncommon in the perioperative period, its associated mortality and long-term disability are high. No large-scale data are available to identify the importance of recognized risk factors for stroke in the perioperative period. A review of the literature shows that the incidence and mechanism of its occurrence are influenced by the presence of cardiovascular disease and the type of surgery. The most common cause of perioperative stroke is embolism. In non-cardiac surgery, the incidence of perioperative stroke is higher among the elderly. Properly administered, controlled hypotension is associated with minimal risk of stroke. Cerebral vasospasm may be the cause of focal cerebral ischaemia in eclamptic patients, and the aggressive treatment of hypertension may exacerbate the neurological damage. The risk of stroke associated with carotid endarterectomy is closely related to the preoperative neurological presentation, and the experience of the surgical/anaesthetic team. Symptomatic cerebrovascular disease, acute stroke, asymptomatic carotid lesions, preoperative assessment of risk, local and general anaesthesia, cerebral protection and monitoring during carotid endarterectomy are discussed with reference to reducing the risk of perioperative stroke. Adequate monitoring and protection have minimized the risk of ischaemia from carotid clamping, and the major mechanism of stroke is embolization.
File Format	PDF HTM / HTML
Alternate Webpage(s)	https://rd.springer.com/content/pdf/10.1007/BF03007628.pdf
PubMed reference number	2036698v1
Volume Number	38
Issue Number	3
Journal	Canadian journal of anaesthesia = Journal canadien d'anesthesie
Language	English
Access Restriction	Open
Subject Keyword	Acute Disease Arteriopathic disease Artificial cardiac pacemaker Cardiovascular Diseases Carotid Artery Diseases Carotid Endarterectomy Carotid-Cavernous Sinus Fistula Cerebral Infarction Cerebrovascular Disorders Cerebrovascular accident Embolism General Anesthesia Hypertensive disease Ischemia Patients Trauma, Nervous System Vasospasm, Intracranial nervous system disorder
Content Type	Text
Resource Type	Article