Pathophysiological and clinical considerations in the perioperative care of patients with a previous ischaemic stroke: a multidisciplinary review.

Minhas, Jatinder S and Rook, William and Panerai, Ronney B and Hoiland, Ryan L and Ainslie, Phil N and Thompson, Jonathan P and Mistri, Amit K and Robinson, Thompson G (2019) Pathophysiological and clinical considerations in the perioperative care of patients with a previous ischaemic stroke: a multidisciplinary review. British journal of anaesthesia. ISSN 1471-6771.

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Official URL: https://bjanaesthesia.org/article/S0007-0912(19)30...

Abstract

With an ageing population and increasing incidence of cerebrovascular disease, an increasing number of patients presenting for routine and emergency surgery have a prior history of stroke. This presents a challenge for pre-, intra-, and postoperative management as the neurological risk is considerably higher. Evidence is lacking around anaesthetic practice for patients with vascular neurological vulnerability. Through understanding the pathophysiological changes that occur after stroke, insight into the susceptibilities of the cerebral vasculature to intrinsic and extrinsic factors can be developed. Increasing understanding of post-stroke systemic and cerebral haemodynamics has provided improved outcomes from stroke and more robust secondary prevention, although this knowledge has yet to be applied to our delivery of anaesthesia in those with prior stroke. This review describes the key pathophysiological and clinical considerations that inform clinicians providing perioperative care for patients with a prior diagnosis of stroke.

Item Type: Article
Subjects: WL Nervous system. Neurology
WO Surgery > WO500 Anaesthesia
Divisions: Clinical Support > Anaesthetics
Related URLs:
Depositing User: Beth Connors
Date Deposited: 13 Dec 2019 16:52
Last Modified: 13 Dec 2019 16:52
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2685

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