gms | German Medical Science

131. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

25.03. - 28.03.2014, Berlin

Rate of neurosurgical relevant complications in the period of early rehabilitation after spontaneous or traumatic intracranial haemorrhages

Meeting Abstract

  • Thomas Kapapa - Universitätsklinikum Ulm, Neurochirurgie, Ulm
  • Pia Linder - Universitätsklinikum Ulm, Neurochirurgie, Ulm
  • Angela Pfaffenzeller - Universitätsklinikum Ulm, Neurochirurgie, Ulm
  • Dieter Woischneck - Klinikum Landshut, Klinik für Neurochirurgie, Landshut

Deutsche Gesellschaft für Chirurgie. 131. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 25.-28.03.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14dgch236

doi: 10.3205/14dgch236, urn:nbn:de:0183-14dgch2364

Published: March 21, 2014

© 2014 Kapapa et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Introduction: There are differences in cooperation between neurosurgeons and early rehabilitation. In some cases rehabilitation is included into a neurosurgical department; other cases show less communication between treating neurosurgeons and rehabilitation staff including physicians. How often is a direct and emergency based cooperation necessary?

Material and methods: 115 patients after intracranial haemorrhage were transferred to the same rehabilitation facility after neurosurgical treatment. All complications during rehabilitation were documented. The study was approved by a local ethics committee.

Results: All patients had phase B of rehabilitation for a minimum of 1 day, maximum of 211 days and a mean of 75.11 days. Highest rates of complications with need of neurosurgical treatment are represented by:

  • 20.2% of the patients developed hydrocephalus, haematocephalus, and dysfunction of liquor shunt, liquor fistula or liquorrhoe,
  • 20% of patients with disturbances of wound healing,
  • 8.8% of the patients developed seizures,
  • 3.5% of the patients developed midline shift due to malign brain edema,
  • 3.5% developed a thromboembolic event.
  • In 1.8% of the patients occurred a secondary herniation, haemorrhage or enlargement of a previously existing haemorrhage
  • Vasospasm occurred in 0.9% of the patients.

A ventriculo-peritoneal-Shunt system must be implanted in 12.3% of the patients while rehabilitation period. 56.5% of the patients presenting disturbances in circulation of cerebrospinal fluid were in need of shunting intervention. 28 (24.3%) patients out of 43 (37.4%) patients after craniectomy underwent cranioplasty.

Conclusion: Patients with spontaneous as well as traumatic intracranial haemorrhages tend to experience relevant cerebral complications with need of neurosurgical intervention. Our data enforce the need of teleradiological connection between a rehabilitation facility and a neurosurgical department.