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

Neuropsychiatric treatment of patients with severe organic brain syndromes occurring after cerebral injury

Die neuropsychiatrische Behandlung von Patienten mit schweren hirnorganischen Psychosyndromen nach zerebralen Schädigungen

Meeting Abstract

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  • corresponding author Michael Amend - Holthausen Hospital Hattingen, Am Hagen 20, 45527 Hattingen
  • W. Mandrella - Holthausen Hospital Hattingen, Am Hagen 20, 45527 Hattingen
  • W. Ischebeck - Holthausen Hospital Hattingen, Am Hagen 20, 45527 Hattingen

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.14.08

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Veröffentlicht: 23. April 2004

© 2004 Amend et al.
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Little has been published to date on the treatment of extremely severe organic brain syndromes, marked by delirium and amnesia, occurring as sequelae of neurosurgical procedures. At Holthausen Hospital we have been treating patients with post-neurosurgical organic brain syndromes of all degrees of severity since 1993. During this time we have observed that the group of patients with pronounced confusional and amnestic disorders, psychomotor restlessness, impulsive outbursts and a tendency to run away - concomitant with a lack of insight into their illness - pose a particular challenge to our ability to provide suitable accommodations, therapeutic concepts and adequate forensic security. The objective of the study is to present the aims of rehabilitation treatment and the outcome of inpatient neuropsychiatric early rehabilitation.


The study population consisted of 1151 randomized patients receiving treatment on two closed wards of a neurosurgical rehabilitation facility during a ten-year period (1993 - 2003). During the study, data were collected on: basic neurosurgical diagnoses, demographic structure, gender, shunt reliance, neuropsychological test results (i.e. of cognition and memory), clinical assessment of the patient's capacity for social and occupational reintegration, discharge objectives and - for patients with aneurysmal subarachnoid hemorrhage (aSAH) - the method (clip or coil) used to treat the aneurysm.


The main basic neurosurgical diagnoses made in the study population were: cranio-cerebral trauma (38.4%), aSAH (32.4 %), spontaneous intracranial bleeding (ICB) (11.8 %) and cerebral tumors (5.7 %.). The average patient age was 53. The breakdown according to gender showed a preponderance of males (71 %). In 23.3 % of the patients, there was an indication for shunt insertion. After receiving treatment based on a multiprofessional interdisciplinary therapeutic concept, the patients displayed an improvement in cerebro-organic symptomatology with respect to cognition, memory and ability to achieve social integration; as a result, 57.2 % of the patients could be reintegrated into their home environment. Of the remaining patients, 18.1% were transferred to special facilities for follow-up rehabilitation treatment, 4.4 % were referred to day treatment centers providing care on a semi- inpatient basis, and 21.2 % were placed in nursing homes or similar facilities.


The results show that neuropsychiatric rehabilitation treatment of patients with extremely severe organic brain syndromes marked by delirium and amnesia constitutes a necessary and worthwhile component of postoperative morbidity management and has a positive impact on outcome.