Postoperative Care: Transitioning from the Intensive Care Unit (ICU) to Regular Ward

After microsurgical treatment of a cerebrovascular lesion, the patient is treated in an intensive care unit where some precautions have to be taken in order to assure a successful overall treatment. In the western world, we have dedicated neurointesive units and staff, which is lacking in developing countries. Nevertheless, the treatment in the intensive care is managed by the cerebrovascular fellows together with the expert. During the fellowship and through every case, the further ICU treatment is discussed with the fellows and supervised by the expert. At the end of the fellowship, the local cerebrovascular fellows could confidently manage the patients in the ICU. The subarachnoid haemorrhages were treated against vasospasm by nimodipine and hypertonia. There was no possibility to diagnose vasospasm with DSA or perfusion imaging; therefore, hypertonia was induced from the beginning until day 14. Cases treated a longer time after SAH did not receive any postoperative nimodipine or hypertonia. These patients where observed in the ICU with controlling the vitals and their neurological status and were transported to the ward the next day.