Air travel after intracranial surgery: a survey of advice given to patients by consultant neurosurgeons in the UK

Objective. Air travel following intracranial surgery is considered to be associated with a risk of tension pneumocephalus. However, the likelihood of it is currently undetermined in the literature. We decided to establish if there was any consensus amongst UK neurosurgeons with regard to advice given to patients. Methods. A questionnaire was approved by the Scientific Meeting Committee of the Society of British Neurological Surgeons (SBNS) and then distributed to all current practicing Consultant Neurosurgeons in the UK via e-mail. Results. 61/66 responders advised patients not to fly for a period of time postoperatively. 35/61 of these neurosurgeons advised a fixed post-operative timescale against flying irrespective of the nature of surgery. The remaining 26/61 advised patients with complex surgical procedures against flying for a longer period. However, the timescales advised by different surgeons in both categories varied between <2 weeks and >8 weeks. Pneumocephalus was the main concern for air travel (42/61) and 17/61 precluded flying due to concerns regarding complications away from home. 3/61 were concerned with deep vein thrombosis. CT scans were obtained prior to discharge by 11/61 of these neurosurgeons. 5/66 neurosurgeons did not advise patients against flying and their advice was independent of the type of surgery. Only one of these 5 neurosurgeons obtained a pre-discharge CT scan. Conclusion. Clinical practice varies widely due to a lack of clear evidence, standards or guidelines. Should the SBNS be producing national guidelines to standardise the advice given to patients?