Recent highlights in periopeative neurological disorders, from bench to bedside

Abstract

Perioperative neurological disorders are important causes of postoperative disability and even perioperative death, bringing a huge challenge to the vulnerable and increasing aging population. Perioperative neurological disorders usually contain ischemic stroke, hemorrhagic stroke, and neurocognitive disorders during the perioperative period. Although a few prevention and treatment strategies have been developed for each disorder, there is still a lack of effective treatments and the underlying mechanisms are far from well-understood. This special issue is dedicated to introducing the recent advances in new strategies towards the management of perioperative neurological disorders. The issue collects research articles and reviews focusing on the neuroprotection mechanisms and application of novel technologies in perioperative neurological disorders, including machine learning and nano-delivery system. These works help to shed lights on developing novel therapeutic targets of perioperative neurological disorders in the pursuit of better recovery and prognosis of the surgical patients. Perioperative neurological disorders are important causes of postoperative disability and even perioperative death, bringing a huge challenge to the vulnerable and increasing aging population. How to cite this article: Guo Y, Li P. Recent highlights in periopeative neurological disorders, from bench to bedside.

Malignancy‐associated ischemic stroke: Implications for diagnostic and therapeutic workup

“…An individualized treatment approach is recommended based on types of malignancies and stroke severities. [90][91][92][93] Moreover, MAS patients with Trousseau syndrome typically have poor survival. Therefore, there is a need to determine the effectiveness of rehabilitation treatment and develop a comprehensive treatment strategy earlier than that in the general stroke population.…”

“…An individualized treatment approach is recommended based on types of malignancies and stroke severities. 90 , 91 , 92 , 93 …”

“…However, additional large, randomized trials are required to address relevant questions of intervention safety and efficacy. An individualized treatment approach is recommended based on types of malignancies and stroke severities 90–93 …”

Perioperative neurocognitive disorders: A narrative review focusing on diagnosis, prevention, and treatment

“…258 Therefore, intervention targeting perioperative inflammation may be effective in the prevention. 259 A 2020 meta-analysis included 8 randomized trials with 1106 patients preparing for orthopedic surgery; the results showed that perioperative parecoxib administration decreased the incidence of delayed neurocognitive recovery and improved Mini-Mental Examination score early after surgery. 260 Parecoxib should be considered in highrisk patients without contraindications.…”

“…Peripheral inflammation provoked by anesthetic exposure and surgery can induce blood–brain barrier disruption 257 ; the resulting neuroinflammation is found to be an important underlying mechanism of perioperative NCDs 258 . Therefore, intervention targeting perioperative inflammation may be effective in the prevention 259 . A 2020 meta‐analysis included 8 randomized trials with 1106 patients preparing for orthopedic surgery; the results showed that perioperative parecoxib administration decreased the incidence of delayed neurocognitive recovery and improved Mini‐Mental Examination score early after surgery 260 .…”