Cerebral vascular insufficiency following minor surgery in the aged

An attempt has been made to emphasize the importance of a neurologic complication of minor surgery. In the later decades of life the decreased adaptability and the presence of arteriosclerosis may be well tolerated until the patient is faced with the need of adjusting to a group of factors, each tending to contribute some degree of transient cerebral anoxia. The effect of these various stresses is cumulative and their sum total is capable of resulting in acute cerebral vascular insufficiency. Based on the physiologic changes involved, certain measures are suggested which would seem to lessen the risk of anoxic damage to the brain. As new drugs and technics steadily increase the human life span, physicians have a vital responsibility to try to keep the added years as free as possible of disabling neurologic symptoms. State hospitals filled with elderly patients who are psychotic due to cerebral vascular damage cannot be considered a tribute to medical progress. Until the problem of preventing the development of arteriosclerosis and hypertension is solved, no practical clinical means of postponing their effects even temporarily should be overlooked.