What follow-up protocols should be implemented for patients with a history of treated cerebral aneurysms?

Follow-up protocols for patients with a history of treated cerebral aneurysms should include:

• Agreeing and documenting a personalised follow-up care plan with the patient after aneurysmal subarachnoid haemorrhage, providing a paper copy to the patient and their carers, and including contact details for specialist advice and support.
• Including the follow-up care plan in the patient's medical record and discharge correspondence to ensure continuity of care.
• Offering rehabilitation in line with NICE guidelines on stroke rehabilitation and rehabilitation after critical illness.
• Considering follow-up neuroimaging based on the type and outcome of the initial aneurysm treatment, presence of any non-culprit aneurysms, estimated risk of further bleeding, risks of investigations and interventions, and patient preference.
• Managing any non-culprit (unruptured) aneurysms through multidisciplinary team evaluation, considering size, location, rupture risk, treatment risks, comorbidities, and patient preferences, with documented management plans.
• Managing blood pressure according to NICE hypertension guidelines to reduce risk of recurrence.
• Not withholding antiplatelet or anticoagulant therapy solely due to history of aneurysmal subarachnoid haemorrhage if the aneurysm has been secured, but balancing risks and benefits with specialist input.

These protocols ensure comprehensive monitoring, risk management, and support for patients post-treatment of cerebral aneurysms.