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Neurointerventional Surgery

Pre-Surgical Testing

Procedures

What is Neurovascular Pre-Surgical Testing?


Neurovascular diseases are prevalent in the general population, and the neurohospitalist has an important role to play in the preoperative planning for patients with and at risk for developing neurological disease. The neurohospitalist can provide patients and their families as well as anesthesiologists, surgeons, hospitalists, and other providers guidance in particular to the patient’s neurological disease and those he or she is at risk for. Here we present considerations and guidance for the neurohospitalist providing preoperative consultation for the neurological patient with or at risk of disturbances of consciousness, cerebrovascular and carotid disease, epilepsy, neuromuscular disease, and Parkinson disease.


Neurohospitalists play an important role in the pr-operative assessment of both patients with and those at risk for the development of neurological disease to help ensure best patient outcomes.

What You Need to Know Before Surgery


If your procedure is surgical, below are tips on how to prepare and what to expect before and after surgery.

Pre-operative Testing

You will need a history and physical examination within two weeks of your scheduled surgery. If you are required by your insurance company to go to your primary care physician, please schedule your own appointment and ask your doctor to fax results to our office as soon as possible. Regardless of insurance, all patients will need an appointment at the Preoperative Center in the Johns Hopkins Outpatient Center . The neurosurgeon's office will schedule your appointment for the following:

  • Review of outside history and physical, if applicable
  • Instructions on eating, drinking, and taking necessary medications before surgery
  • A nurse or doctor will discuss anesthesia and what will happen before surgery which could include blood tests, chest X-ray, EKG, MRI or CT scan, and meetings with other doctors if you have any special medical problems

This visit will last several hours and will be scheduled one day to one week prior to surgery.

Consent Forms

Your physician at the Pituitary Tumor Center will talk to you about the risks and benefits of surgery. After the surgery is explained to you, you will be asked to sign three consent forms. When possible, this will take place during your clinic visit.

Medications

Everyone's medication needs are different. You will continue to take most of your regular medications before and after your surgery. Depending on your procedure, you may be required to discontinue taking aspirin or anti-inflammatory drugs. Your physicians will discuss this with you in further detail, but please call your neurosurgeon's office if you have any questions about medications. When you are discharged from the hospital after the surgery you will also get additional instructions on how to continue to take the medications at home.

Admission

You will most likely be admitted on the day of surgery. An IV will be placed in your arm. Other IVs and catheters will be placed after you are asleep. This will be explained to you at the preoperative visit.

Surgeon

In addition to your surgeon, anesthesiologists, nurses, and one or more physician assistants will be in the operating room. Surgery may last a few or many hours. The operating room staff will give your family updates during the surgery. As soon as surgery is over, the physician will talk to your family.

After Surgery


After Surgery, you may be taken to the intensive care unit, or you may have a short stay in the Recovery Room before going to the Nursing Unit. You will have IV's and a heart monitor on as well as a catheter in your bladder. A loose-fitting mask may be placed over your mouth, which will deliver oxygen. A typical hospital stay is four days after surgery.

You should not have a lot of pain. Most people just take Tylenol after the surgery. Let your nurse know if you have any pain. Your medications can be changed accordingly.

We expect that you will be out of bed eating and taking short walks the day after surgery. You will be getting IV antibiotics for four days after surgery. The nurses will keep track of what you eat and drink as well as how much you urinate.

You can bring some comfortable clothes (bathrobe, for example) to wear after surgery.

Post-operative Visit

We ask that you call your neurosurgeon's office to arrange a postoperative visit with your surgeon. Your endocrinologist and otolaryngologist will most likely want to see you as well.

If you are having a non-surgical procedure, additional lab or blood tests may be required after the procedure. This testing can be done at Hopkins or at your primary care physician's office. Prior to discharge you will receive specific instructions and information about any additional testing and follow up visits.