‘Silent’strokes common in seniors after surgery

Canadian researchers say socalled “silent” strokes are common in seniors after they have elective, non-cardiac surgery and double their risk of cognitive decline one year later.

Cardiologist and co-lead researcher PJ Devereaux of Hamilton Health Sciences says that “silent” – or covert – strokes are actually more common than overt strokes in surgery patients aged 65 or older.

While an overt stroke causes obvious symptoms such as weakness in one arm or speech problems, a covert stroke is not obvious except on brain scans.

Overt stroke occurs in less than one per cent of adults after noncardiac surgery but researchers found that covert stroke occurred among seven per cent of the 1,114 study participants.

The global study detected MRI evidence of the more subtle condition among 78 patients aged 65 years and older who underwent surgery between March 24, 2014, and July 21, 2017.

These patients were also more likely to experience cognitive decline, delirium, overt stroke or a mini-stroke within one year, compared to patients who did not have a silent stroke. The results of the NeuroVISION study were published Thursday in The Lancet.

Co-lead investigator, Dr. Marko Mrkobrada of Western University, said the findings underscore the risks involved when older patients undergo surgery, especially as improving surgical and anesthetic techniques allow surgeons to operate on older and sicker patients.