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[Cerebral infarction during operation on the neck of the femur under epidural anesthesia: a report of two cases].

Cerebral infarction occurred during operation in two cases. An 83-year-old senile demented female underwent osteosynthesis with Ender pins under epidural anesthesia. Soon after Ender pins were inserted, her systolic blood pressure fell from 180 mmHg to 140 mmHg. The patient complained of chest pain and developed disturbed consciousness and right hemiparesis. On the second postoperative day, CT scanning showed the infarction of a left middle cerebral artery region. A 93-year-old female was another patient. She underwent a cup arthroplasty of the right hip bone fracture. Soon after bone cement was applied, she developed a mental confusion and her blood pressure increased from 120/60 mmHg to 160/80 mmHg. CT scanning on the first postoperative day showed the infarction of a left middle cerebral artery region. Sudden changes in systolic blood pressure and changes of mental status are possible signs of cerebral infarction not to be neglected. If elderly patients with any episodes of cerebral function troubles would undergo operation of the hip fracture, it is necessary to pay a particular attention to possible cerebral infarction.