Can Haste in Pre-Anaesthetic Check-up Increase the Chances of Post-Operative Stroke: A Case Report

Background: In cardiac, neurologic, and carotid surgery, the incidence of stroke is known to be high (2.2-5.2%). Laparoscopy has been considered as low risk for stroke. Here we report a case of stroke in patient who underwent laparoscopic nephrectomy. Previous history of stroke was not disclosed at the time of surgery. Effect on intra-operative management due to this lapse and how it could have been rectified, has been discussed here. Case presentation: This article reports a case of post-operative stroke in a 58 yr old male with moderate obesity that underwent laparoscopic nephrectomy under general anesthesia. Patient did not give any history of previous transient ischemic attack (TIA) although he had an episode of the same a year back. Intraoperatively, anti-hypertensives were used to control high blood pressure. Post extubation it was noted that he was unable to vocalize and move right upper and lower limbs. CT scan revealed fresh watershed infarct in frontoparietal region and an old infarct in occipital region. Conclusion: Importance of history taking especially in elderly patients cannot be undermined. It is important not only for intraoperative management but for risk stratification and medico legal purpose as well.