Anesthetic management of hip fracture surgery in a patient with concurrent cardio-cerebral infarction: a case report

Cardio-Cerebral Infarction (CCI), defined by the simultaneous occurrence of acute myocardial infarction (AMI) and acute ischemic stroke (AIS), is a rare clinical entity associated with high mortality. Currently, no consensus exists regarding its optimal management strategy or the timing of surgical intervention. We present the case of a 79-year-old female admitted for a hip fracture who subsequently developed Cardio-Cerebral Infarction. Following multidisciplinary evaluation and medical stabilization, she underwent femoral head replacement under general anesthesia combined with a fascial iliaca compartment block. Cranial MRI confirmed an acute ischemic lesion in the right parietal lobe. The diagnosis of concurrent AMI was established based on ST-segment deviations on electrocardiography, significantly elevated high-sensitivity troponin-I levels, and echocardiographic evidence of regional wall motion abnormalities. The patient received combined anticoagulation and antiplatelet therapy in the intensive care unit (ICU). Once hemodynamic stability was achieved, surgery was performed using an individualized anesthetic protocol designed to minimize hemodynamic fluctuations and ensure cerebral perfusion. At the 10-month follow-up, the patient reported satisfactory recovery with no apparent long-term complications.