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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Functional outcome, quality of life, anxiety and depression after brainstem cavernoma resection – long-term follow up

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  • Annika Herten - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Karsten H. Wrede - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Oliver Müller - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Ramazan Jabbarli - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Rebecca Leyrer - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Ulrich Sure - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Philipp Dammann - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV134

doi: 10.3205/18dgnc136, urn:nbn:de:0183-18dgnc1362

Published: June 18, 2018

© 2018 Herten et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: To assess functional outcome, health related quality of life, anxiety and depression in patients that underwent brainstem cavernoma (CCM) resection >24 months ago.

Methods: We performed a cross-sectional study based on our uni-center CCM database (2008-2017), using a standardized interview in all eligible and available patients (modified Rankin score, SF-36 questionnaire, HADS-D score, neurological examination).Results were matched with various pre- and postoperative clinical and MRI parameters.

Results: We (so far) included n=30 (48%) of 61 eligible patients (overall brainstem CCM surgical cohort n=83).Mean age was 48.8±13.12 years (18 female, 12 male). Modified Rankin score was ≤ 1 in 15 patients (50%), 2-3 in 13 patients (43%) and ≥4 in 2 patients (7%). 6 patients (20%) were not completely independent (mRs≥3) in every day life. SF-36 results showed significantly decreased mental health sum-scores as well as decreased scores for physical and social functioning, emotional role and body role compared to age matched German reference cohort (p<0.05). 5 patients (15%) showed increased levels (≥11, HADS-A) of anxiety. 6 patients (20%) showed increased levels (≥11, HADS-D) of depression. Overall outcome parameters correlated with specific brainstem location of CCM and elapsed time after surgery (reflecting further improvement/adaption in longer term postoperative course).

Conclusion: Brainstem surgery of CCM may lead to massive neurological and health-related quality of life impairment. Our results may help to select patients that are of higher or lower risk of such postoperative deterioration and may thus balance the indication for surgery.