ABSTRACT
Stroke is the leading cause of disability worldwide and the fourth leading cause of death in the United States. Stroke may be hemorrhagic or ischemic in etiology, although a majority of them (85") are ischemic in origin. Anesthesiologists are involved in the care of the patients with acute ischemic stroke (AIS) at several levels. This may include airway management in the emergency department, neurointerventional procedures under anesthesia, and operating room including hemicraniectomy and the neurocritical care unit. The causes of AIS may be embolic, for example, atrial fibrillation or thromboembolic including carotid artery disease. Patients may be at risk for aspiration if they develop facial or bulbar weakness or altered mental status. Neurogenic pulmonary edema may occur with severe cerebral ischemia and lead to hypoxemia. Patients may develop respiratory failure and require urgent intubation. Every effort must be made for a quick neurologic assessment prior to intubation, to determine baseline status.
