Stroke as a complication of noncerebrovascular surgery

Although improvements in perioperative care have resulted in the ability to perform complex operations in elderly, high-risk patients, serious complications can occur. One such complication is perioperative stroke. Most strokes occur 3-30 days following a surgical procedure. Perioperative stroke complicating noncerebrovascular surgery is uncommon, but it can be associated with devastating disability and high mortality (1). With the exception of death, long-term neurological disability following postoperative stroke is undoubtedly an elderly patient’s most feared perioperative complication (2). Patients who have suffered a perioperative stroke can present a formidable social and financial burden to the family and community. All surgeons who operate on elderly, high-risk patients must be familiar with the risk factors for stroke, the incidence of perioperative stroke associated with various procedures, and variables that can be modified to reduce the risk of perioperative stroke.