We report a case of 72 years old male patient , known hypertensive for 5 years with moderate to severe bladder outlet obstruction posted for TURP. He was operated under a sub-arachnoid block and the intraoperative course was uneventful. Subsequently he was observed in the post operative ward. The neurological status of the patient deteriorated after 5 hours with acute surge in blood pressure. A CT scan revealed B/L Gangliocapsular& Right Thalamic Infarcts.

He was successfully managed by supportive care. There was complete neurologic recovery over the next 5 days and was discharged from the hospital subsequently.

This case aims to highlight the risk of perioperative stroke in susceptible patients. Its awareness and early recognition can reduce the morbidity and mortality in such patients.

Hypertension is the commonest avoidable medical indication for postponing anaesthesia and surgery. There isno universally accepted guidelines stating the arterial pressure values at which anaesthesia should be postponed. Longstanding hypertension is associated with damage to coronary, renal and cerebral circulations. Although most frequent seen with neurosurgery and cardiovascular surgery, perioperative stroke is also a recognized complication in non-cardiac, nonvascular surgery. Although perioperative stroke is reported to have an incidence of 0.05-7%, there is sparse scientific literature available of its occurrence and outcome in non-cardiac, nonvascular surgery. Most are thrombotic in origin and are noted after discharge from the post anaesthetic care unit. Common pre disposing factors include age, a previous stroke , atrial fibrillation and vascular and metabolic diseases. We report a case of 72 years old male patient , known hypertensive for 5 years with moderate to severe bladder outlet obstruction posted for TURP.He was operated under a sub-arachnoid block and the intraoperative course was uneventful.Subsequently he was observed in the post operative ward. The neurological status of the patient deteriorated after 5 hours with acute surge in blood pressure. A CT scan revealed B/L Gangliocapsular& Right Thalamic Infarcts. He was successfully managed by supportive care. There was complete neurologic recovery over the next 5 days and was discharged from the hospital subsequently. This case aims to highlight the risk of perioperative stroke in susceptible patients. Its awareness and early recognition can reduce the morbidity and mortality in such patients.