Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3170
Peer-review started: December 6, 2020
First decision: December 21, 2020
Revised: February 6, 2021
Accepted: February 26, 2021
Article in press: February 26, 2021
Published online: May 6, 2021
Processing time: 136 Days and 23.5 Hours
Perioperative stroke is a rare but devastating complication. The risk factors for massive cerebral stroke in surgical patients include older age, male sex, prior cerebrovascular disease, hypertension, renal failure, smoking, diabetes mellitus, and atrial fibrillation.
We describe two cases of perioperative massive cerebral stroke following thoracic surgery and one case following bronchoscopy. Neurologic symptoms, including changes in mental status and hemiplegia, occurred within 10 h after surgery in the three patients. All three patients died after the surgery.
Perioperative massive cerebral stroke may be more likely to occur in thoracic surgical patients if there are pre-existing factors including previous stroke, hypotension, and hypoxemia. Sufficient pain control after surgery and timely neurology consultation and management are helpful for the diagnosis and control of stroke in high-risk patients.
Core Tip: Perioperative stroke is a rare but devastating complication; however, the risk factors for perioperative stroke remain unclear. Two cases following thoracic surgery and one case following bronchoscope presented with perioperative massive cerebral stroke are documented in this case series. The risk factors for perioperative massive cerebral stroke in thoracic patients include previous stroke, hypotension, and hypoxemia. Sufficient pain control after surgery and timely neurology consultation and management are helpful for diagnosis and control of stroke in high risk patients.