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60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit den Benelux-Ländern und Bulgarien

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

24. - 27.05.2009, Münster

Favorable long-term outcome of patients with traumatic injuries of the corpus callosum without infratentorial lesions

Meeting Abstract

  • M. Hof - Klinik und Poliklinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Klinikum der Universität zu Köln
  • M. Lippert-Grüner - Klinik und Poliklinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Klinikum der Universität zu Köln
  • E. Spüntrup - Abteilung für Neuroradiologie, Institut und Poliklinik für Radiologische Diagnostik, Klinikum der Universität zu Köln
  • S. Weber - Klinik und Poliklinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Klinikum der Universität zu Köln
  • R.-I. Ernestus - Klinik und Poliklinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Klinikum der Universität zu Köln
  • M. Löhr - Klinik und Poliklinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Klinikum der Universität zu Köln

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP01-07

DOI: 10.3205/09dgnc255, URN: urn:nbn:de:0183-09dgnc2553

Veröffentlicht: 20. Mai 2009

© 2009 Hof 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 vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: The prognostic significance of traumatic corpus callosum injuries (TCCI) as depicted by magnetic resonance imaging (MRI) of patients with moderate and severe traumatic brain injury (TBI) is not yet clear, but several reports indicate an unfavorable long-term outcome. The purpose of this retrospective study was to determine the impact of TCCI on late neurological recovery and the quality of life with respect to additional intra- and extracranial injuries as well as to the exact localization of the lesion within the corpus callosum. Furthermore, we wondered if TCCI entail any distinctive pattern of neuropsychological deficits in the long term.

Methods: 19 patients with moderate and severe TBI and TCCI were analyzed. Cases showing an additional infratentorial lesion were deliberately excluded since their outcome is usually poor and mainly determined by brain stem dysfunction. Clinical, electrophysiological, and MRI-findings from the acute stage and during follow-up were evaluated retrospectively. Outcome was estimated in terms of the Glasgow-Outcome-Scale, by neuropsychological examination and standardized assessments of patients’ quality of life. Mean follow-up was 13 months (range: 8–60 months).

Results: 18 of the 19 patients had a good or excellent clinical outcome, and only one showed moderate disability. No patient exhibited a callosal disconnection syndrome, neither shortly after TBI nor during follow-up, but neuropsychological deficits like disturbances of alertness and memory impairments were more likely associated with lesions in the posterior trunk or the splenium of the corpus callosum. On the other hand, callosal atrophy in late MRI controls as demonstrated in some patients was not related to any specific neurological or neuropsychological sequelae. Persisting neurological deficits in several patients could always be attributed to concomitant supratentorial lesions.

Conclusions: TCCI without additional infratentorial lesions do not predict an unfavorable neurological long-term outcome. Since injuries of the posterior corpus callosum seem to inflict impairments of alertness and memory, patients with TCCI should be thoroughly examined in neuropsychological respects to prevent rehabilitational defaults.