Cerebral protection: Inflammation, endothelial dysfunction, and postoperative cognitive dysfunction

Abstract

PURPOSE OF REVIEW: Postoperative cognitive dysfunction (POCD) is a well recognized perioperative syndrome, with approximately 15% of patients over the age of 60 years displaying objectively measured decrease in cognitive function as a consequence of anesthesia and surgery. The exact cause, however, remains unknown. This review aims to update anesthesiologists on the recent advancements in the understanding of the pathophysiology of POCD. RECENT FINDINGS: Recent evidence suggests that the observed predilection to POCD is likely mediated by a neuro-inflammatory response-with surgery being a major contributing factor. The blood-brain barrier, a highly specialized endothelial layer, is exquisite..