What is the primary sign that indicates an intraoperative stroke?

The primary sign indicating an intraoperative stroke is often sudden neurological changes, which can manifest as seizures. Intraoperative strokes can disrupt normal blood flow to the brain, leading to acute neurological symptoms. When a patient experiences a stroke during surgery, it may cause a seizure due to the abnormal electrical activity in the brain resulting from the ischemic or hemorrhagic event. This is particularly relevant in the context of intraoperative monitoring, where prompt identification of seizures can be critical for timely intervention.

While loss of consciousness, difficulty breathing, and sudden vision loss can be related to various intraoperative complications, they are not the most specific indicators of a stroke in this setting. Loss of consciousness may be due to anesthesia effects, breathing difficulties can arise from other pulmonary complications, and vision loss can happen for multiple reasons, including pressure on the optic nerve or systemic issues. Seizures, however, would more specifically suggest an acute change in cerebral function, closely associated with the occurrence of a stroke.