title: From preoperative evaluation to stroke center: Management of postoperative acute ischemic stroke.
abstract: Perioperative acute ischaemic stroke is a rare complication with potentially catastrophic outcomes. It has been shown that paying attention to perioperative neurological deficits and acute ischaemic stroke prevention proves to be beneficial in avoiding these catastrophic outcomes and may lead to determining early therapeutic interventions. This article reviews the perioperative management (covering diagnosis and treatment), prevention (covering surgery postponement, management with anticoagulant/antiplatelet and the growing interest in statins and beta-blockers) and intraoperative recommendations (covering anaesthetic techniques, ventilation strategies, transfusion and blood pressure management) specifically for the general surgical population. A summary of current treatments is enlightened by recently described evidence for the effectiveness of mechanical thrombectomy.
authors.affiliation: Neurosurgical Anaesthesiology Department, La Pitié Salpêtrière Hospital, 75013 Paris, France; Paris VI University Pierre-et-Marie-Curie, 75013 Paris, France; Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Thomas
authors.initials: T
authors.lastname: Boyer
authors.affiliation: Inserm U1141, Robert-Debré Hospital, 75019 Paris, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Sigaut
authors.affiliation: Neurosurgical Anaesthesiology Department, La Pitié Salpêtrière Hospital, 75013 Paris, France; Inserm U1141, Robert-Debré Hospital, 75019 Paris, France; Neuroscience Department, La Pitié Salpêtrière Hospital, 75013 Paris, France; Neuroradiology Department, La Pitié Salpêtrière Hospital, 75013 Paris, France; Paris VI University Pierre-et-Marie-Curie, 75013 Paris, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Puybasset
authors.affiliation: Neuroscience Department, La Pitié Salpêtrière Hospital, 75013 Paris, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Deltour
authors.affiliation: Neuroradiology Department, La Pitié Salpêtrière Hospital, 75013 Paris, France; Paris VI University Pierre-et-Marie-Curie, 75013 Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Clarençon
authors.affiliation: Neurosurgical Anaesthesiology Department, La Pitié Salpêtrière Hospital, 75013 Paris, France; Inserm U1141, Robert-Debré Hospital, 75019 Paris, France; Neuroscience Department, La Pitié Salpêtrière Hospital, 75013 Paris, France; Neuroradiology Department, La Pitié Salpêtrière Hospital, 75013 Paris, France; Paris VI University Pierre-et-Marie-Curie, 75013 Paris, France. Electronic address: vincent.degos@inserm.fr.
authors.forename: Vincent
authors.initials: V
authors.lastname: Degos
mesh_terms: D002545:Brain Ischemia / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D019990:Perioperative Care; D011183:Postoperative Complications / Q000517:prevention & control / Q000628:therapy*; D020521:Stroke / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D017131:Thrombectomy
keywords: Mechanical thrombectomy; Neurologic complication; Non-cardiac surgery; Stroke