Perioperative strokes in neurosurgical patients: risk factors and prevention methods (literature review)
E. L. Semenov,
P. A. Podoplelov,
D. V. Protasova,
K. V. Nikulova,
L. M. Tsentsiper,
A. N. Kondratyev https://doi.org/10.24884/2078-5658-2026-23-4-123-131
Abstract
Introduction. Cerebrovascular diseases are the most acute medical and social problems. Perioperative stroke (POS) may occur at the time of making a decision on the need for surgical treatment, preoperative preparation, intraoperative period, as well as within 30 days after surgery.
The objective was to estimate the modern idea of risk factors, incidence rate and methods of prevention of perioperative stroke in neurosurgical patients.
Materials and methods. The search of publications in data base (MEDLINE, PubMed, Scopus, Google Scholar, International Clinical Trials Registry Platform of the World Health Organization (ICTRP ,who.org), ClinicalTrials.gov, eLibrary.ru had done. The last date of publications was December, 31st 2025. The main keywords: arterial aneurysms, carotid stenoses, brain tumors, neurosurgery, endovascular surgery, perioperative stroke, prevention methods. Inclusion criteria: full-text articles, reviews, and meta-analyses. Non-inclusion criteria: clinical cases, untranslated articles, articles published before 2005. The 213 articles were found. As a result of the selection according to the criteria of inclusion and non-inclusion, 50 sources were included in the review.
Results. POS is a potentially fatal complication that significantly increases the risk of adverse outcomes. Significant risk factors for the development of POS are: old age, kidney disease, previous transient ischemic attack or stroke, myocardial infarction during the previous 6 months, atrial fibrillation, hypertension, chronic obstructive pulmonary disease, smoking, female gender and diabetes mellitus. Patients who have undergone emergency surgery or surgical procedures on the head and neck are at a higher risk of developing POS. Despite the successes of modern surgery, anesthesiology, and intensive care, the frequency of POS has not decreased. The search for effective methods of POS prevention continues.
About the Authors
E. L. Semenov
Polenov Neurosurgical Institute – Branch of the Almazov National Medical Research Centre
Russian Federation
Russian Federation
Semenov Evgeniy L., Research Fellow of the Research Laboratory of Neuroprotection and Neurometabolic Disorders, Anesthesiologist-Intensivist
12, Mayakovskogo str., Saint Petersburg, 191014
P. A. Podoplelov
Polenov Neurosurgical Institute – Branch of the Almazov National Medical Research Centre
Russian Federation
Russian Federation
Podoplelov Pavel A., Anesthesiologist-Intensivist
12, Mayakovskogo str., Saint Petersburg, 191014
D. V. Protasova
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Protasova Diana V., Postgraduate Student, Department of Anesthesiology and Intensive Care with a Clinic at the Institute of Medical Education, Anesthesiologist-Intensivist
2, Litovskaya str., Saint Petersburg, 194100
K. V. Nikulova
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Vikulova Kristina V., Resident, Department of Anesthesiology and Intensive Care with a Clinic at the Institute of Medical Education
2, Akkuratova str., Saint Petersburg, 197341
L. M. Tsentsiper
Polenov Neurosurgical Institute – Branch of the Almazov National Medical Research Centre; Almazov National Medical Research Centre; Saint Petersburg State Pediatric Medical University; Peoples’ Friendship University of Russia named after Patrice Lumumba
Russian Federation
Russian Federation
Tsentsiper Lubov M., Dr. of Sci. (Med.), Professor of the Department of Anesthesiology and Intensive Care with a Clinic at the Institute of Medical Education; Leading Research Fellow of the Research Laboratory of Neuroprotection and Neurometabolic Disorders, Anesthesiologist-Intensivist, Endocrinologist; Professor of the Department of Anesthesiology, Intensive Care and Emergency Pediatrics, Faculty of Postgraduate and Additional Professional Education; Professor of the Department of Anesthesiology and Intensive Care with a Course in Medical Rehabilitation, Medical Institute
12, Mayakovskogo str., Saint Petersburg, 191014
2, Akkuratova str., Saint Petersburg, 197341
2, Litovskaya str., Saint Petersburg, 194100
6, Miklukho-Maklaya str., Moscow, 117198
A. N. Kondratyev
Polenov Neurosurgical Institute – Branch of the Almazov National Medical Research Centre
Russian Federation
Russian Federation
Kondratyev Anatoly N., Dr. of Sci. (Med.), Professor, Head of the Research Laboratory of Neuroprotection and Neurometabolic Disorders
12, Mayakovskogo str., Saint Petersburg, 191014
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Review
For citations:
Semenov E.L., Podoplelov P.A., Protasova D.V., Nikulova K.V., Tsentsiper L.M., Kondratyev A.N. Perioperative strokes in neurosurgical patients: risk factors and prevention methods (literature review). Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2026;23(4):123-131. (In Russ.) https://doi.org/10.24884/2078-5658-2026-23-4-123-131
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