- Normotension and normovolemia: Normal range MAPs and adequate hydration should be maintained during the postoperative period.
- ICU: Overnight observation at the PICU is recommended for frequent neurological evaluation.
- Activity and diet: If extubation is tolerated, activity out of bed is encouraged and diet should be resumed with a successful swallow study.
- Seizure treatment: Continue antiepileptic medical treatment if the patient presented with seizures.
- Testing: Blood count and basic metabolic panel should be ordered on day one.
- Imaging: If any change in neurological status is present, emergent CT without contrast should be obtained.
- Anticoagulation treatment: Consider anticoagulation if venous thrombosis is present. Consult Hematology.
- Neurological deficits: In addition to the common surgical complications, venous infarction can develop if normal venous drainage is accidentally interrupted.
- Cranial nerves palsy: Ligation of feeding arteries, especially if very proximal, could theoretically damage cranial nerves, as a significant part of their vascularization originates from dural branches.
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