Update in the Evaluation and Management of Perioperative Stroke

  • Dilip Kumar Jayaraman
  • Sandhya Mehla
  • Saurabh Joshi
  • Divya Rajasekaran
  • Richard P. GoddeauJrEmail author
Cerebrovascular Disease and Stroke (S Silverman, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cerebrovascular Disease and Stroke


Purpose of review

This review will review the current knowledge and gaps in the literature on the relationship between surgery and ischemic stroke.


Surgery and ischemic stroke are interrelated phenomena as surgery is an independent risk factor for stroke and perioperative stroke increases morbidity and mortality leading to poor outcomes after surgery. This relationship and the risk of adverse outcome apply not only the clinically apparent stroke in the perioperative period but also clinically silent brain infarction detected only on radiological studies. The risk of perioperative stroke depends on several factors including (i) patient-related factors (age, history of prior stroke, and other comorbidities), (ii) procedure-related factors (type of surgery/procedure, use of cardiopulmonary bypass, antiplatelet/antithrombotic interruption, and metabolic derangement), and (iii) perioperative atrial fibrillation.


With observation and retrospective data, the literature is limited to prevention and management of perioperative stroke.


Perioperative stroke Ischemic stroke Risk prevention Atrial fibrillation 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Dilip Kumar Jayaraman
    • 1
  • Sandhya Mehla
    • 1
  • Saurabh Joshi
    • 2
  • Divya Rajasekaran
    • 3
  • Richard P. GoddeauJr
    • 1
    Email author
  1. 1.Department of NeurologyUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Division of Cardiology, Department of MedicineUniversity of Connecticut School of MedicineFarmingtonUSA
  3. 3.Division of Neuroradiology, Department of RadiologyUniversity of Massachusetts Medical SchoolWorcesterUSA

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