Chronic neurological disorders encompass a broad range of challenges for
the surgical and anesthesiology team in the perioperative setting. According to the
World Population Prospects 2019, by 2050, 1 in 6 people will be over 65, from 1 in 11
in 2019 [1]. As our population continues to age, our understanding and ability to
provide medical and surgical services must improve as well. Perioperative strokes are
rare, but they can greatly impact a patient's recovery and function when they occur.
Dementia strongly predicts postoperative complications, higher hospital costs, and 30-
day mortality [2]. Patients with Parkinson’s disease are at a higher risk of perioperative
medical and surgical complications not to mention specific medication regimens that
need to be adjusted to avoid worsening symptomatology. Although rare, a patient
presenting with Amyotrophic lateral sclerosis (ALS), can present with a broad range of
neurologic symptoms, and cardiovascular and pulmonary dysfunction that can be
daunting for any anesthesia provider. In this chapter, we will explore the
comprehensive approach to managing chronic neurologic disorders, including
multidisciplinary care, early identification of potential complications, specialized
medication management, and intraoperative considerations.
Keywords: Alzheimer's Dementia, Bradykinesia, Beer’s criteria, Frontotemporal dementia, Ischemic stroke, Lewy body dementia, Perioperative stroke, Pick’s disease, Postoperative delirium (POD), Parkinson's disease, TPA exclusion criteria.
