NEUROANESTHESIA: Edited by Lingzhong MengAnesthesia and the brain after concussionPasternak, Jeffrey J.; Abcejo, Arnoley S.Author Information Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA Correspondence to Jeffrey J. Pasternak, MD, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN 55905, USA. Tel: +1 507 255 4235; fax: +1 507 255 6463; e-mail: [email protected] Current Opinion in Anaesthesiology: October 2020 - Volume 33 - Issue 5 - p 639-645 doi: 10.1097/ACO.0000000000000906 Buy Metrics Abstract Purpose of review To provide an overview of acute and chronic repeated concussion. We address epidemiology, pathophysiology, anesthetic utilization, and provide some broad-based care recommendations. Recent findings Acute concussion is associated with altered cerebral hemodynamics. These aberrations can persist despite resolution of signs and symptoms. Multiple repeated concussions can cause chronic traumatic encephalopathy, a disorder associated with pathologic findings similar to some organic dementias. Anesthetic utilization is common following concussion, especially soon after injury, a time when the brain may be most vulnerable to secondary injury. Summary Brain physiology may be abnormal following concussion and these abnormalities may persist despite resolutions of clinical manifestations. Those with recent concussion or chronic repeated concussion may be susceptible to secondary injury in the perioperative period. Clinicians should suspect concussion in any patient with recent trauma and strive to maintain cerebral homeostasis in the perianesthetic period. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.