Univariate correlates for the development of poor neurological outcome were tested using the Mann-Whitney test, unpaired t test, and Fisher exact test. Statistical significance was set to P<0.05. Independent predictors for poor neurological outcome were assessed by multiple logistic regression. Predictors with a P value of <0.1 in the univariate analysis were included in the logistic regression analysis. Analyses were performed using the GraphPad Prism 5 software (GraphPad PRISM Software, version 6.01, Inc., La Jolla) and PASW Statistics 18.0 (SPSS). ResultsOne hundred eight patients were evaluated with age 70 (62-77) years, National Institutes of Health Stroke Scale score of 21 (18-24), and modified Rankin Scale score of ≤2 in 38%Background and Purpose-In retrospective studies, patients receiving general anesthesia for endovascular treatment for acute ischemic stroke have worse neurological outcome compared with patients receiving conscious sedation. It has been suggested that this is caused by general anesthesia-associated hypotension. We investigated the effect of intraprocedural hypotension on neurological outcome. Methods-One hundred eight patients with acute ischemic stroke, who underwent endovascular treatment in general anesthesia between 2007 and 2012, were included. Analyzed predictors of neurological outcome were age, sex, comorbidities, baseline National Institutes of Health Stroke Scale, intraprocedural relative changes in mean arterial blood pressure from baseline, blood glucose, modified Thrombolysis in Cerebral Infarction score, and elapsed time from stroke to computed tomography, groin puncture, and recanalization/end of procedure. Results-A fall in mean arterial blood pressure of >40% was an independent predictor for poor neurological outcome (P=0.032), as were higher admission National Institutes of Health Stroke Scale score (P=0.008) and lack of recanalization (P=0.003). Conclusions-Profound intraprocedural hypotension is an independent predictor for poor neurological outcome in patients with acute ischemic stroke undergoing endovascular therapy in general anesthesia. (Stroke. 2015;46:2678-2680.

No abstract

Cardiac surgery with CPB causes a profound cerebral inflammatory response, which was accompanied by increased post-operative CSF levels of the AD biomarker Aβ(1-42) . We hypothesize that these changes may be relevant to Alzheimer-associated amyloid build-up in the brain and cognitive dysfunction after cardiac surgery with CPB.