Purpose of Review The significance of stroke in the noncardiac, nonneurologic, and nonvascular perioperative setting has been routinely underestimated. A complex interplay of multiple perioperative, patient, and surgical factors is involved in the pathogenesis of perioperative stroke. Multiple risk reduction strategies are required to decrease the incidence of this devastating complication. Recent Findings Recent evidence demonstrates that one in every 1000 patients undergoing low-risk surgery may develop perioperative stroke which can result in significant morbidity or mortality. The incidence of covert stroke is much higher. Further, it is now established that the majority of strokes do not occur during or immediately after surgery but at least 24 h later-thus emphasizing the need for active surveillance. Summary A high index of suspicion throughout the perioperative period, prompt diagnosis, and immediate management based on a multidisciplinary protocol is the key for successful outcome. In this article, we review recent evidence pertaining to this topic. We also suggest a model clinical care pathway for institutional management of perioperative stroke that could form the basis of multidisciplinary care.
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