Up to two percent of patients will experience a stroke during or after surgery and these patients have a high chance of disability and death. Currently, we don’t understand clearly how to prevent, detect, and treat stroke after surgery. Although risk factors have been identified including older age and cardiac surgery, high risk surgical patients are not usually identified and strokes can be missed, leading to fewer treatment options and more complications. My previous pilot study showed that anesthesia and surgery can limit the accuracy of standard screening tools for stroke. We urgently needed a screening tool and protocol specifically for surgical patients. We also don’t understand well how patients recover after perioperative stroke, such as which patients survive, and whether they can stay in their homes. Building on our prior research, this multiphase study aims to: (1) Understanding which patients do poorly after perioperative stroke and whether those factors can be changed; (2) Compare mortality and other complications after stroke between those who had recent surgery and those who did not; and (3) Identify a useful perioperative stroke screening tool to quickly and accurately detect stroke after surgery.