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    "story_id": "mp-2026-08-04-001",
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    "headline": "The Quiet Brain Damage Spoke Before Surgery",
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    "dek": "A heavier small-vessel disease burden on preoperative MRI was associated with nearly doubled odds of delirium after noncardiac surgery.",
    "summary": "A heavier small-vessel disease burden on preoperative MRI was associated with nearly doubled odds of delirium after noncardiac surgery.",
    "body_text": "A prospective study followed 804 adults ages 65 to 85 undergoing elective noncardiac surgery at five academic centers in China. Sixty-nine patients, or 9 percent, developed delirium during the first three postoperative days. The rate rose to 28 percent among those with the highest MRI-measured small-vessel disease burden, and high burden was associated with an adjusted odds ratio of 1.95; lacunes had the strongest individual association. The result identifies a preexisting risk marker, not a causal mechanism, a validated individual prediction rule or a recommendation for routine MRI screening.",
    "why_it_matters": "A heavier small-vessel disease burden on preoperative MRI was associated with nearly doubled odds of delirium after noncardiac surgery.",
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      "A prospective study followed 804 adults ages 65 to 85 undergoing elective noncardiac surgery at five academic centers in China.",
      "The result identifies a preexisting risk marker, not a causal mechanism, a validated individual prediction rule or a recommendation for routine MRI screening."
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        "text": "A heavier small-vessel disease burden on preoperative MRI was associated with nearly doubled odds of delirium after noncardiac surgery.",
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    "tags": [
      "surgery",
      "delirium",
      "brain imaging",
      "small-vessel disease"
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      "source_id": "source-2026-08-04-001",
      "title": "Anesthesiology: cerebral small-vessel disease and postoperative delirium",
      "publisher": "Wolters Kluwer Health",
      "url": "https://doi.org/10.1097/aln.0000000000006189",
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  "cite_this_report": {
    "title": "The Quiet Brain Damage Spoke Before Surgery",
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    "published_at": "2026-08-04T09:00:00.000-04:00",
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