Postoperative central nervous system dysfunction

This chapter reviews common forms and causes of central nervous system (CNS) morbidity in the elderly after routine surgery and anesthesia. These include, in order of descending prevalence, delirium, prolonged postoperative cognitive dysfunction (POCD), and perioperative stroke. Although these same conditions are also common during and after cardiac surgery, we will not deal with those situations here because the contributing factors are somewhat different and cognitive morbidity after cardiac surgery is a topic unto itself. We begin with a brief overview of how the brain changes during healthy and pathologic aging because aging of the CNS is a prominent factor in determining susceptibility to cognitive and neurologic morbidity after surgery and anesthesia. © 2008 Springer Science+Business Media, LLC.