Central nervous system dysfunction after anesthesia in the geriatric patient.

Cerebral infarction, bleeding, long-lasting hypofusion, and profound hypoxia are well-known factors behind central nervous system dysfunction after anesthesia. Other explanations may be the metabolic-endocrine stress response and psychologic factors related to changes in the environment. The clinical presentations can be obvious as in cerebral death or stroke but delirium also may be readily recognized. A more subtle and long-lasting deterioration in cognitive function is called postoperative cognitive dysfunction. This condition can only be detected with the use of neuropsychologic testing and recently, postoperative cognitive dysfunction has been detected as the most common cerebral complication after noncardiac surgery in elderly patients.