Preoperative preparation of the surgical patient with neurologic disease

This article emphasizes some key points in the preoperative evaluation of patients with neurologic disease. The amount of neurologic disease in the general population is a difficult number to assess accurately. This is, in part, because of the wide-sweeping scope of neurologic disease. The International Classification of Diseases has the highest number of conditions attributable to neurologic disease. Patients with neurologic disease are commonly encountered, and their illness is often complicated by significant comorbid disease. It is important to think of the patient as a whole rather than the sum of his or her systems. While it is tempting to consider the traditional preoperative evaluation from a "cardiac clearance" point of view, we must resist this urge, and evaluate which risk factors we can modify and hopefully mitigate to optimize the perioperative period.