[Preoperative evaluation and prognosis of patients with cerebrovascular disease].
Stroke remains a major perioperative problem for anesthesiologists. In this article, we have described preoperative evaluation and prognosis of patients with cerebrovascular disease. Cerebral infarction accounts for more than 60% of stroke. In patients with recently developed ischemic stroke, a surgery should be delayed at least for a month. Carotid artery stenosis accounts for 15 to 20% of ischemic stroke. In these patients, since the incidence of cardiovascular disease is common, cardiovascular examinations may be required preoperatively. The efficacy of carotid endarterectomy (CEA) to prevent stroke is well established, whereas carotid artery stenting (CAS) has been increasingly advocated as less invasive treatment. Several studies have indicated that the risks of CAS are higher than those of CEA, suggesting that CAS may not be used in good surgical candidates. In the patients with subarachnoid hemorrhage (SAH), preoperative assessments of cardiac and respiratory condition are required. It is reported that unfavorable outcome after SAH is related to rebleeding and cerebral vasospasm.
Egawa
Junji
J
Department of Anesthesiology, Nara Medical University, Kashihara 634-8521.
Kawaguchi
Masahiko
M
Furuya
Hitoshi
H
D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D011300:Preoperative Care