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Perioperative stroke : a perspective on challenges and opportunities for experimental treatment and diagnostic strategies

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Jin, Xia, Li, Peiying, Michalski, Dominik, Li, Shen, Zhang, Yueman, Jolkkonen, Jukka, Cui, Lili, Didwischus, Nadine, Xuan, Wei and Boltze, Johannes (2022) Perioperative stroke : a perspective on challenges and opportunities for experimental treatment and diagnostic strategies. CNS Neuroscience & Therapeutics, 28 (4). pp. 497-509. doi:10.1111/cns.13816 ISSN 1755-5930.

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Official URL: https://doi.org/10.1111/cns.13816

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Abstract

Perioperative stroke is an ischemic or hemorrhagic cerebral event during or up to 30 days after surgery. It is a feared condition due to a relatively high incidence, difficulties in timely detection, and unfavorable outcome compared to spontaneously occurring stroke. Recent preclinical data suggest that specific pathophysiological mechanisms such as aggravated neuroinflammation contribute to the detrimental impact of perioperative stroke. Conventional treatment options are limited in the perioperative setting due to difficult diagnosis and medications affecting coagulation in may cases. On the contrary, the chance to anticipate cerebrovascular events at the time of surgery may pave the way for prevention strategies. This review provides an overview on perioperative stroke incidence, related problems, and underlying pathophysiological mechanisms. Based on this analysis, we assess experimental stroke treatments including neuroprotective approaches, cell therapies, and conditioning medicine strategies regarding their potential use in perioperative stroke. Interestingly, the specific aspects of perioperative stroke might enable a more effective application of experimental treatment strategies such as classical neuroprotection whereas others including cell therapies may be of limited use. We also discuss experimental diagnostic options for perioperative stroke augmenting classical clinical and imaging stroke diagnosis. While some experimental stroke treatments may have specific advantages in perioperative stroke, the paucity of established guidelines or multicenter clinical research initiatives currently limits their thorough investigation.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- )
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Cerebrovascular disease -- Treatment, Ischemia -- Treatment, Preoperative care
Journal or Publication Title: CNS Neuroscience & Therapeutics
Publisher: Wiley
ISSN: 1755-5930
Official Date: April 2022
Dates:
DateEvent
April 2022Published
27 February 2022Available
4 February 2022Accepted
Volume: 28
Number: 4
Page Range: pp. 497-509
DOI: 10.1111/cns.13816
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 15 March 2022
Date of first compliant Open Access: 18 March 2022
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
NAF\R11\1010Academy of Medical Scienceshttp://dx.doi.org/10.13039/501100000691
20DZ2254200Shanghai Engineering Research Center of Perioperative Organ Support and Function PreservationUNSPECIFIED
91957111[NSFC] National Natural Science Foundation of Chinahttp://dx.doi.org/10.13039/501100001809
82061130224[NSFC] National Natural Science Foundation of Chinahttp://dx.doi.org/10.13039/501100001809

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