Postoperative Neurologic Complications in the Older Adult

Purpose of ReviewThe older patient population is at increased risk of postoperative neurologic complications. With an ever-increasing proportion of older adults requiring advanced surgical interventions, surgeons should be knowledgeable in contemporary diagnostic and management paradigms. In this re...

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Bibliographic Details
Published inCurrent geriatrics reports Vol. 13; no. 2; pp. 61 - 69
Main Authors Gummadi, Sriharsha, Pascual L, Jose L
Format Journal Article
LanguageEnglish
Published New York Springer Nature B.V 01.06.2024
Subjects
Consciousness
Convulsions & seizures
Critical care
Delirium
Etiology
General anesthesia
Heart surgery
Hypertension
Hypotension
Ischemia
Mortality
Patients
Risk factors
Sepsis
Stroke
Thrombosis
Transient ischemic attack
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Summary:Purpose of ReviewThe older patient population is at increased risk of postoperative neurologic complications. With an ever-increasing proportion of older adults requiring advanced surgical interventions, surgeons should be knowledgeable in contemporary diagnostic and management paradigms. In this review, we detail neurologic complications common encountered in elderly populations, reviewing relevant literature and practices.Recent FindingsCommon postoperative neurologic complications in the elderly include delirium, cerebrovascular accidents, and seizures. The mainstay of treatment of postoperative delirium is non-pharmacologic management. Postoperative cerebrovascular disorders require prompt diagnosis and evaluation for revascularization (if ischemic) or decompressive (if hemorrhagic) therapies, recognizing certain recent updates have changed guidelines. Preoperative anti-epileptic drug optimization is the most important approach to preventing postoperative seizures in epileptic patients.SummaryA standardized and systematic approach in managing postoperative neurologic complications is paramount, particularly in the older adult. This includes a comprehensive history (including review of preexisting medications and drug use), physical exam, chemical analysis (glucose, electrolytes, infectious evaluation, blood gas), and axial neurologic imaging, lumbar puncture, or electroencephalogram when indicated. Early expert consultation with a neurologist or neurosurgeon is often warranted.
ISSN:2196-7865
2196-7865
DOI:10.1007/s13670-024-00409-8