gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Outcome of patients after hemicraniectomy in malignant middle cerebral artery infarction after first rehabilitation

Lebensqualität von Patienten nach dekompressiver Hemikraniektomie bei Infarkten im Stromgebiet der Arteria cerebri media nach durchgeführter erster Rehabilitationsmaßnahme

Meeting Abstract

Suche in Medline nach

  • corresponding author Guido Ketter - Neurologisches Rehabilitationszentrum Godeshoehe e.V., Bonn
  • J. Kuest - Neurologisches Rehabilitationszentrum Godeshoehe e.V., Bonn
  • H. Karbe - Neurologisches Rehabilitationszentrum Godeshoehe e.V., Bonn

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.14.07

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0140.shtml

Veröffentlicht: 23. April 2004

© 2004 Ketter et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

In cases of infarctions of the middle cerebral artery with secondary development of clinical or radiological signs of herniation the benefit of decompressive craniectomy is described to decrease mortality. After this therapy early rehabilitation therapy is necessary to increase the quality of life.

Methods

Fifteen patients in median age of 47,5 which were treated with decompressive hemicraniectomy after life threatening middle cerebral infarction underwent early rehabilitation therapy between February 2002 and September 2003 in our neurological rehabilitation clinic. 12 patients suffered on right sided infarction, 3 of them have had left side damage. The rehabilitation time was in average 107 days. To characterise quality of life after rehabilitation time we used early rehabilitation-barthel index, barthel index from admission and departure in comparison, neuropsychological deficits, Rankin-scale, Glasgow-outcome-score and care after rehabilitation.

Results

After acute therapy in average of 33,1 days the median early rehabilitation barthel-index at admission was -125 with a median barthel index of 0. At depature median early rehabilitation barthel-index increasd to -25 whereas median barthel index increased to 40 (median). Neuropsychological deficits could be seen in 13 cases: 10 of 13 right side brain damaged patients showed a neglect, all left side affected (3) have had aphasic disorders. Looking for outcome scales median Rankin scale was 4, median GOS 3. One of the patients was able to live independent in her own home after rehabilitation, 11 patients needed help in their own home, three patients went to nursing home.

Conclusions

The study shows, that after long rehabilitation time most patients who underwent hemicraniectomy after life threatening middle cerebral infarction needed for care but were able to reintegrate in their own home. Younger patients (< 47,5 years, n=8) had better outcome and reached a higher quality of life than older people. Cause of the low population further investigations in a prospective study are necessary.