Stroke is the most common cause of disability in elderly people (over 65years of age) and the third most common cause of death in the world . The World Health Organization estimates that one in six people globally will suffer from stroke in their lifetime.

Perioperative stroke is the most unwanted complication for patients, as well as for surgeons and anesthesiologists . The reported risk of perioperative stroke varies with the type of surgery. Its incidence is generally not high (approximate 0.1-1.9%) in non-cardiac, non-neurologic, and non-major surgery However, it may occur in up to 10% of patients undergoing high-risk cardiac or brain surgery . Patients with perioperative stroke are less likely to have a good functional outcome and have an eight-fold higher mortality compared with those without perioperative stroke

Inclusion Criteria:

1. all Patients admitted to General surgery, cardiothorasic surgery and vascular surgery Depatments in assuit university hospitals during one year that will going to operation
2. ALL age Groups .
3. Both Sex.

Exclusion Criteria:

• Other surgical departments
• Patients with Syptoms that related to delayed recovery from anaesthesia .

all Patients admitted to General surgery, cardiothorasic surgery and vascular surgery Depatments in assuit university hospitals during one year that will going to operation