The incidence of stroke post neck dissection surgery and perioperative management
Title
The incidence of stroke post neck dissection surgery and perioperative management
Creator
Samyuktha Melachuri
Manasa Melachuri
Benita Vallapil
Seungwon Kim
Carl Snyderman
Date
2022
Description
Background: Head and neck surgery encompasses major vessels, raising the concern of life-threatening complications such as stroke.
Methods: Databases at UPMC were queried to identify patients with both neck dissections and stroke from January 1st, 2004, to October 1st, 2020. A retrospective chart review was performed to identify patients who experienced a stroke within 30 days of a neck dissection.
Results: Search of a UPMC database for carotid artery stenosis (CAS), transient ischemic attack (TIA), and stroke identified 20,527 patients. After matching with the Head and Neck Tumor Registry patients, 41 of 4230 patients with a neck dissection also had a stroke, TIA, or CAS in their lifetime. One patient, with multiple risk factors, despite pre-operative precautions, had a stroke 2 days post neck dissection in the setting of carotid occlusion from hypercoagulability of malignancy and intraoperative vessel injury. The patient subsequently underwent a carotid thrombectomy and vein patch repair and has had no additional cerebrovascular accidents.
Conclusion: Although the incidence of stroke post neck dissection is minimal, patients with multiple risk factors for stroke should be managed carefully to prevent deleterious outcomes.
Methods: Databases at UPMC were queried to identify patients with both neck dissections and stroke from January 1st, 2004, to October 1st, 2020. A retrospective chart review was performed to identify patients who experienced a stroke within 30 days of a neck dissection.
Results: Search of a UPMC database for carotid artery stenosis (CAS), transient ischemic attack (TIA), and stroke identified 20,527 patients. After matching with the Head and Neck Tumor Registry patients, 41 of 4230 patients with a neck dissection also had a stroke, TIA, or CAS in their lifetime. One patient, with multiple risk factors, despite pre-operative precautions, had a stroke 2 days post neck dissection in the setting of carotid occlusion from hypercoagulability of malignancy and intraoperative vessel injury. The patient subsequently underwent a carotid thrombectomy and vein patch repair and has had no additional cerebrovascular accidents.
Conclusion: Although the incidence of stroke post neck dissection is minimal, patients with multiple risk factors for stroke should be managed carefully to prevent deleterious outcomes.
Source
Am J Otolaryngol
. 2022 Mar-Apr;43(2):103360. doi: 10.1016/j.amjoto.2021.103360. Epub 2021 Dec 24.
. 2022 Mar-Apr;43(2):103360. doi: 10.1016/j.amjoto.2021.103360. Epub 2021 Dec 24.
Language
English
URL
https://doi.org/10.1016/j.amjoto.2021.103360
Citation
Samyuktha Melachuri et al., “The incidence of stroke post neck dissection surgery and perioperative management,” NEOMED Bibliography Database, accessed May 2, 2024, https://neomed.omeka.net/items/show/12079.