Medical care of the neurosurgical patient

Proper medical care before and after surgery play an important role in the overall care of patients requiring neurosurgery and will have an impact on the neurological recovery. Prevention of spinal cord destruction resulting from the cascade of events which occur secondary to central nervous system trauma is a critical part of a patient's preoperative care. High doses of methylprednisolone sodium succinate given within the first 8 hours of trauma are currently recommended to provide protection to neural tissue after trauma. Other promising drugs for patients with spinal trauma, such as 21-aminosteroids and GM-1 gangliosides, may become available in the near future. Knowledge of potential complications after surgery and methods to prevent complications from occurring is an important part of the postoperative care of neurosurgical patients. This includes management of micturition and defecation dysfunction, management of postoperative pain, physical therapy to speed recovery, and providing good supportive care to the recumbent patient.