title: Perioperative stroke in a patient undergoing surgery for oral cancer: A case report.
abstract: Carotid artery stenosis is a significant risk factor for stroke. In elderly patients with carotid atherosclerosis and stenosis, it is not unusual for oral, head and neck cancer surgery to be performed. The present study describes a case of stroke that occurred during a neck dissection for the treatment of cervical lymph node metastasis of a left maxillary gingival carcinoma. The patient was an 84-year-old female who was considered to be at high risk of a stroke based on pre-operative head and neck computed tomography scans, which detected severe carotid atherosclerosis and stenosis. There was no possible stroke prophylaxis available during the performance of the neck dissection in the present case. However, if patients are evaluated to be high-risk pre-operatively, statin agents should be administered, the surgery should be carefully performed, adequate sedation should be maintained post-operatively and the patient should be followed up, aiming to achieve the early detection of a possible stroke.
authors.affiliation: Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa 760-8557, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Sukegawa
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kanno
authors.affiliation: Department of Otorhinolaryngology, Kagawa Prefectural Central Hospital, Kagawa 760-8557, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Kanai
authors.affiliation: Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa 760-8557, Japan.
authors.forename: Toshiko
authors.initials: T
authors.lastname: Mandai
authors.affiliation: Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa 760-8557, Japan.
authors.forename: Akane
authors.initials: A
authors.lastname: Shibata
authors.affiliation: Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa 760-8557, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Otorhinolaryngology, Kagawa Prefectural Central Hospital, Kagawa 760-8557, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hirata
authors.affiliation: Department of Otorhinolaryngology, Kagawa Prefectural Central Hospital, Kagawa 760-8557, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Furuki
keywords: carotid atherosclerosis; neck dissection; oral squamous cell carcinoma; perioperative complication; stroke