**Postoperative Cognitive Dysfunction: Preclinical Highlights and Perspectives on Preventive Strategies Postoperative Cognitive Dysfunction: Preclinical Highlights and Perspectives on Preventive Strategies**

Fabricio M. Locatelli and Takashi Kawano Fabricio M. Locatelli and Takashi Kawano Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/66574

#### **Abstract**

[9] Hoeffner EG, Case I, Jain R, Gujar SK, Shah GV, Deveikis JP, Carlos RC, Thompson BG, Harrigan MR, Mukherji SK. Cerebral perfusion CT: technique and clinical applications.

[10] Lui YW, Tang ER, Allmendinger AM, Spektor V. Evaluation of CT perfusion in the settings of cerebral ischemia: patterns and pitfalls. Am J Neuroradiol 2010; 31: 1552–63.

[11] Mair G, Wardlaw JM. Imaging of acute stroke prior to treatment: current practice and

Radiology 2004; 231: 632–44.

128 Current Topics in Anesthesiology

evolving techniques. Br J Radiol 2014; 87: 20140216.

One of the common complications associated with anaesthesia and surgery in geriatric patients is the postoperative cognitive dysfunction (POCD). This cognitive impairment affects the long-term prognosis and has been shown to be associated with long-term disability, higher health care costs, and even increased mortality. On the other hand, clinical research on POCD is in its infancy, the condition has not been clarified, and since no strategy for management is currently available, it is imperative to develop specific methods for prevention and management. Although its pathogenesis involves various factors, accumulating evidence suggests that surgery elicits an inflammatory response in the hippocampus, a brain area closely related to cognitive function, playing a key role in the development of POCD. Several studies suggest that age-related phenotypic change of microglia is associated with pathogenic neuroinflammation, and more importantly it may be modifiable. In this chapter, we discuss the current overview and preclinical highlights regarding POCD. We further discuss some perspectives on preventive strategies for POCD, based on the findings of our preclinical research and the available literature.

**Keywords:** POCD, neuroinflammation, microglia
