Do patients have any special medical or rehabilitation difficulties after a craniectomy for malignant cerebral infarction during their hospitalization in a physical medicine and rehabilitation department?
OBJECTIVE
To observe whether medical complications, the evolution of neurological disorders and dependence and/or the discharge destinations are different for patients treated by craniectomy for malignant cerebral infarction in the middle cerebral artery compared to patients treated medically for severe or malignant cerebral infarction in the same cerebral territory, during their hospitalization in a physical medicine and rehabilitation department.


METHODS
This retrospective study compared patients treated by craniectomy for malignant cerebral infarction in the middle cerebral artery and patients treated medically for severe or malignant cerebral infarction in the same cerebral territory. Patients were paired according to age, lesion side and hospitalization period.


RESULTS
Twelve patients treated by craniectomy (age 43+/-10.44) were paired with 12 patients treated medically (age 49+/-7.66). The two groups were comparable in terms of general undesirable medical events. The medical events related to craniectomy are described. The evolution of patient deficiencies, the length of the hospital stay (194+/-118.93 days vs 152+/-94.64 days), the Functional Independence Measure at discharge (87+/-21.28 vs 95+/-22.19) and the number of direct home discharges (7 vs 9) did not significantly differ between groups.


CONCLUSIONS
No more medical problems were observed in the patients treated by craniectomy than in the patients treated medically, except for the medical events specifically related to craniectomy, which extended the hospital stay but had no major repercussions.
Mandon
L
L
AP-HP, université Paris, France.
Bradaï
N
N
Guettard
E
E
Bonan
I
I
Vahedi
K
K
Bousser
M G
MG
Yelnik
A
A
D000328:Adult; D001925:Brain Damage, Chronic / Q000209:etiology / Q000517:prevention & control; D001929:Brain Edema / Q000209:etiology / Q000601:surgery; D015897:Comorbidity; D003399:Craniotomy / Q000009:adverse effects / Q000534:rehabilitation*; D004677:Encephalocele / Q000517:prevention & control; D005260:Female; D006748:Hospital Departments; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000188:drug therapy / Q000534:rehabilitation / Q000601:surgery*; D007297:Inpatients / Q000706:statistics & numerical data; D020766:Intracranial Embolism / Q000188:drug therapy / Q000534:rehabilitation / Q000601:surgery; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010810:Physical and Rehabilitation Medicine / Q000458:organization & administration*; D011183:Postoperative Complications / Q000209:etiology / Q000534:rehabilitation*; D020127:Recovery of Function; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology