Article
Rate of neurosurgical relevant complications in the period of early rehabilitation after spontaneous or traumatic intracranial haemorrhages
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Published: | March 21, 2014 |
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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.