Jian MY, Liang F, Liu HY, Han RQ. Perioperative massive cerebral stroke in thoracic patients: Report of three cases. World J Clin Cases 2021; 9(13): 3170-3176 [PMID: 33969105 DOI: 10.12998/wjcc.v9.i13.3170]
Corresponding Author of This Article
Ru-Quan Han, MD, Chief Doctor, Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, No. 119 Southwest 4th Ring Road, Beijing 100070, China. ruquan.han@ccmu.edu.cn
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 6, 2021; 9(13): 3170-3176 Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3170
Perioperative massive cerebral stroke in thoracic patients: Report of three cases
Min-Yu Jian, Fa Liang, Hai-Yang Liu, Ru-Quan Han
Min-Yu Jian, Fa Liang, Hai-Yang Liu, Ru-Quan Han, Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Author contributions: Jian MY and Liang F were the patient’s anesthesiologists, reviewed the literature, and contributed to manuscript drafting; Liu HY reviewed the literature and contributed to manuscript drafting; Han RQ was responsible for the revision of the manuscript for important intellectual content; all authors gave final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patients’ families for the publication of this case series and the accompanying images.
Conflict-of-interest statement: The authors have no conflict of interest to state.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ru-Quan Han, MD, Chief Doctor, Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, No. 119 Southwest 4th Ring Road, Beijing 100070, China. ruquan.han@ccmu.edu.cn
Received: December 6, 2020 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
