Abstract
A comprehensive preoperative assessment of elderly patients undergoing intracranial surgeries can reduce perioperative morbidity and mortality. Elderly patients often present with a wide array of comorbid medical conditions and extensive medication lists, which may influence the preoperative evaluation, anesthetic plan, and perioperative care. This article provides a basic overview of the preoperative assessment of elderly patients undergoing intracranial surgeries.
Highlights
BackgroundAs the increase in life expectancy and our ability to detect new pathology grows, physicians today are operating on a higher proportion of neurosurgical elderly patients as compared to years before [1]
Patients often present with a wide array of comorbid medical conditions and extensive medication lists, which may influence the preoperative evaluation, anesthetic plan, and perioperative care
The growing trend of more elderly patients undergoing elective intracranial surgeries highlights the importance of conducting a comprehensive preoperative assessment of elderly neurosurgical patients to reduce perioperative morbidity and mortality
Summary
As the increase in life expectancy and our ability to detect new pathology grows, physicians today are operating on a higher proportion of neurosurgical elderly patients as compared to years before [1]. The management of preoperative anticoagulation cessation in elderly neurosurgical patients is complex since such patients have many comorbidities (atrial fibrillation, mechanical valves) that increase their risk of thromboembolism. Further consultation is needed when the risk of thromboembolism is higher in patients with atrial fibrillation, systemic embolism, and mechanical valves In these individuals, the warfarin cessation time should be minimized, and bridging therapy with heparin should be initiated preoperatively and stopped a few hours prior to surgery [18]. Some elderly patients undergoing elective intracranial surgeries may have restricted mouth opening or limited neck mobility due to a variety of reasons, including cervical spine disease, acromegaly, high intracranial pressure, or old-age limitations In such patients, performing the upper lip bite test is a quick and accurate method to evaluate the airway. The anesthesiologist and surgeon must agree and must use high-level communication before, during, and after the operation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
