Hemostasis Today
NewsFeed
Headlines Hematology Health Medicine VTE ASH Plasma Donation
June, 2026
June 2026
M T W T F S S
1234567
891011121314
15161718192021
22232425262728
2930  
Arnaud Baldivia: Peri-Procedural Stroke – An Underestimated Emergency in the Operating Room and in the ICU
Arnaud Baldivia/LinkedIn
Apr 29, 2026, 02:18

Arnaud Baldivia: Peri-Procedural Stroke – An Underestimated Emergency in the Operating Room and in the ICU

Arnaud Baldivia, Founder of Vox Medica, shared a post on LinkedIn:

“Peri-procedural stroke: an underestimated emergency in the operating room and in the ICU

A sudden neurological deficit in the perioperative setting is never trivial.

And above all: it’s not up to us to guess — it’s up to the imagery to decide.

The 2026 RFE GIHP/SFAR finally clarify the course of action to be taken.

The key reflex

Any neuro deficit is equal to stroke until proven otherwise

  • Unexplained delay in waking up
  • Hemiparesis/facial asymmetry
  • Aphasia, impaired consciousness
  • Gaze Deviation

Immediate care

  • Supine position
  • Emergency brain imaging (parenchyma + vessels)
  • Call for neurovascular team
  • NO antithrombotics before imaging

Blood pressure: Hypertension is respected up to 220/120 mmHg

The antihypertensive reflex in the ICU can be deleterious

No benefit demonstrated in lowering BP in the acute phase

What really changes in 2026

  • Reperfusion possible up to 24 hours
  • Early resumption of DOACs validated:

Minor stroke – 48 hours
Moderate/severe stroke – no more than day 4

End of the dogma ‘wait 7–14 days’

The real issue

Delicate balance between:

  • Cerebral ischaemic risk
  • Post-operative bleeding risk

Decision still individualized, but framework finally clarified

4 reflexes to remember

  • Sudden deficit is equal imaging plus immediate neurovascular
  • Zero antithrombotics before CT/MRI
  • Wide Blood Pressure Tolerance (≤ 220/120)
  • Early DOAC recovery according to severity

In practice:

This is not an uncommon complication… it is a complication that is not well recognized.

And in this context, every minute counts as much as in pre-hospital ‘Time is Brain’.”

Arnaud Baldivia

Stay updated with Hemostasis Today.

2026 RFE GIHP/SFAR Arnaud Baldivia Health Hematology Hemostasis Hemostasis News Hemostasis Today ICU Medicine Peri-procedural stroke
NewsFeed