[Thoracic surgery when the patients have cerebrovascular disease]

In cancer patients, cerebrovascular disease is recognized as the 2nd most common complication involving the central nervous system. Once cancer occurs in stroke patients, or vice versa, neurological outcomes significantly worsen and prognosis tends to be poor. Perioperative stroke after noncardiac, nonneurosurgical procedures is more common than generally acknowledged. It is reported to have an incidence of 0.05~7.4% of patients. "The analysis of lung cancer registry for resected cases in 1994", jointly established by the Japan Lung Cancer Society and the Japanese Association for Chest Surgery, reported a 2.4% frequency of cerebrovascular disease. Cerebrovascular disease is an unavoidable comorbidity for thoracic surgeons. Most are thrombotic in origin and are noted after discharge from the postanesthetic care unit. The mortality is more than 2 times greater than in strokes occurring outside the hospital. Delayed diagnosis and a synergistic interaction between the inflammatory changes normally associated with stroke, and those normally occurring after surgery, may explain this increase. Emergency non-contrast scanning of the brain is the primary diagnostic brain imaging study for evaluation of patients with suspected stroke, and the goal is to complete the computer tomography examination within 25 min of the provisional diagnosis being made.