What post-operative care should I provide for patients after neurosurgery to ensure optimal recovery?

Post-operative care after neurosurgery should include:

• Monitoring and managing hydrocephalus: Assess for acute or chronic hydrocephalus based on symptoms and imaging, and consider cerebrospinal fluid drainage or diversion if neurological deterioration occurs ¹.
• Ensuring euvolaemia and managing delayed cerebral ischaemia: Maintain normal blood volume and consider vasopressor treatment if symptoms of delayed cerebral ischaemia persist after subarachnoid haemorrhage ¹.
• Developing and documenting a follow-up care plan: Agree on a follow-up plan with the patient, provide a paper copy to them and their carers, and include the plan in medical records and discharge summaries ¹.
• Offering rehabilitation: Provide rehabilitation in line with NICE guidelines on stroke rehabilitation and rehabilitation after critical illness to support recovery ¹.
• Follow-up neuroimaging: Consider follow-up imaging based on recovery extent and clinical need ¹.
• Surveillance for late effects in brain tumour patients: Monitor for late-onset side effects such as cognitive decline, epilepsy, hearing loss, and endocrine dysfunction, and provide appropriate referrals for neuropsychology, ophthalmology, audiology, and stroke services as needed ².
• Communication and support: Provide clear, honest information to patients and carers, manage expectations, and ensure a clear point of contact for ongoing advice and support ⁴.
• Specialist involvement: For spinal cord injuries or complex neurosurgical cases, ensure early involvement of specialist neurosurgical or spinal surgeons and coordinated care with spinal cord injury centres ⁴.