Abstract
Cerebral damage after general anesthesia at a university hospital over a 20-year period was studied retrospectively. There were 14 cases of cerebral damage associated with intra-or post-operative events among 32, 642 anesthetic cases (excluding cardiovascular surgery patients). The average age was 60 years (range 1-80 years). As for the surgical site, five cases were abdominal, three were intrathoracic, three were cervical, two were spinal operations and one was a pediatric bronchoscopy. The most frequent cause of cerebral damage was ventilatory insufficiency (seven patients). Other causes were circulatory insufficiency (four patients), cerebral infarction (two patients), and cerebral hemorrhage (one patient). Six cases (42%) were judged to be mainly due to anesthesia, four cases (29%) to the surgery, and four cases (29%) to the patients' condition. Cardiac arrest occurred in eight patients. Four patients died, four patients suffered from mild permanent neurologic deficits, and six patients fully recovered. To avoid cerebral sequelae, adequate preanesthe-tic assessment and preparation and pen-anesthetic management are vital. The development of a non-invasive monitoring device for cerebral circulation and metabolism is also urgently needed.
