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[Perioperative stroke after esophageal surgery].
Yoshiko Mizuno1, Ikuko Miyawaki, Hiroko Kato
1Department of Anesthesia, Kobe City General Hospital, Kobe 650-0046.
Masui. the Japanese Journal of Anesthesiology
|August 18, 2005
Summary
A stroke occurred in a patient undergoing esophagectomy due to severe carotid artery stenosis. Preoperative carotid screening may help identify at-risk patients for stroke prevention.
Area of Science:
- Cardiology
- Neurology
- Vascular Surgery
Background:
- A 65-year-old male underwent extended esophagectomy with general anesthesia.
- Preoperative imaging revealed aortic arch calcification, a potential risk factor.
Observation:
- The patient developed left eye deviation and right hemiparesis postoperatively.
- Computed tomography confirmed cerebral infarction in the left middle cerebral artery territory.
Findings:
- Severe left internal carotid artery stenosis was diagnosed via ultrasonography.
- Intraoperative cerebral emboli from carotid manipulation were suspected as the cause.
Implications:
- This case highlights the risk of stroke in patients with undiagnosed carotid atherosclerosis undergoing major surgery.
- Preoperative carotid ultrasonography screening is suggested for early detection and stroke prevention.