Different Strokes for Operative Folks: Prevention of the Perioperative Cerebrovascular Accident

Abstract

S troke is the third-leading cause of death in the United States and has been well characterized as a highly morbid disease. The goal of this chapter is to review the epidemiological and clinical scope of perioperative stroke, the mechanisms by which such strokes occur, and how perioperative management can serve to optimize the clinical outcome of these patients. In line with the American Society of Anesthesiologists’ goal of implementing the perioperative surgical home, the concepts discussed here are highly applicable to the daily practice of anesthesiology. Although several of the concepts discussed are not yet monitored from a Medicare quality metric perspective, the prevention and management of perioperative stroke is likely to rise to the forefront of anesthetic quality measurement in the near future.