naa a22 4500 510744478 CHVBK 20180411083041.0 cr unu---uuuuu 180411e20130201xx s 000 0 eng 10.1007/s12630-012-9857-7 doi (NATIONALLICENCE)springer-10.1007/s12630-012-9857-7 Review article: The role of hypotension in perioperative stroke [Elektronische Daten] [Jilles Bijker, Adrian Gelb] Article de synthèse: Le rôle de l'hypotension dans l'accident vasculaire cérébral périopératoire Purpose: A stroke is an uncommon but potentially devastating complication after surgery. Although hypoperfusion is often mentioned as a possible cause of a perioperative stroke, a thorough investigation is needed into the role of intraoperative and/or postoperative hypotension in the occurrence and development of perioperative cerebral ischemia. In this review article, we present an overview of the available literature on the possible role of hypotension in perioperative stroke, and we place these studies in a broader context. Principal findings: Perioperative strokes are most frequently thromboembolic in origin and commonly occur within the first 72 postoperative hours after a symptom-free interval. Case reports have shown a causal relationship between hypotension and perioperative stroke; nevertheless, many other factors contribute to its pathophysiology. Hypotension contributes as a primary factor or likely more frequently as a secondary factor in the development of a perioperative stroke. Among the main difficulties in studying this association is the lack of standardized definitions of perioperative hypotension, baseline blood pressure, and the length of the postoperative period. To guide future research, we propose a selection of problems to address in order to gain more insight into the problem of perioperative cerebral ischemia. Conclusions: Unusually low blood pressure will eventually result in neurological damage; however, the threshold and duration at which an association might be found between a perioperative stroke and hypotension have not been well investigated. Thus, the exact role of hypotension in the etiology of perioperative stroke is still largely unknown. Canadian Anesthesiologists' Society, 2012 Bijker Jilles Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands aut Gelb Adrian Department of Anesthesia & Perioperative Care, University of California San Francisco, 521 Parnassus Ave, C450, 94143-0648, San Francisco, CA, USA aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/2(2013-02-01), 159-167 0832-610X 60:2<159 2013 60 12630 https://doi.org/10.1007/s12630-012-9857-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-012-9857-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bijker Jilles Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Gelb Adrian Department of Anesthesia & Perioperative Care, University of California San Francisco, 521 Parnassus Ave, C450, 94143-0648, San Francisco, CA, USA aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/2(2013-02-01), 159-167 0832-610X 60:2<159 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer