title: Long-term Functional Recovery and Quality of Life after Surgical Treatment of Putaminal Hemorrhages.
abstract: BACKGROUND
  To evaluate the long-term functional recovery and health-related quality of life (HRQOL) in patients after surgically treated putaminal hemorrhages. Surgery for putaminal hemorrhages remains a controversial issue. Although numerous reports describe conflictive results regarding short-term outcome of surgically treated patients, very little is known about their long-term recovery and their HRQOL.
  
  
  METHODS
  In this monocentric, retrospective study we analyzed mortality, long-term functional outcome, activity of daily life status, and HRQOL undergoing craniotomy for hematoma evacuation between December 2004 and January 2011.
  
  
  RESULTS
  Forty-nine consecutive patients were identified with 8 (16.3%) patients dying during acute care. Forty-one patients surviving acute phase were transferred to neurologic rehabilitation hospitals. One patient was lost to follow-up. Median follow-up was 52.9 (17-101) months. At follow-up, 24 of 40 (60%) patients still were alive with 16 of 40 (40%) patients living with major disability (modified Rankin Scale [mRS], 4 or 5). Seven patients (17.5%) showed a mRS lesser than or equal to 3 with only 3 (7.5%) of those living functionally independent (mRS, 0-2). HRQOL in survivors was reduced with a median DEMQOL/DEMQOL (a patient/caregiver reported outcome measure designed to assess health-related quality of life of people with dementia) proxy score of 92 and 93, respectively. All patients showed severe impairment in activities of daily life.
  
  
  CONCLUSIONS
  This is the first long-term follow-up analysis for patients with surgically treated putaminal hemorrhages. Survivors show only marginal recovery despite intensive neurologic rehabilitation; most remain dependent with a reduced HRQOL and significantly impaired activities of daily life status.
authors: Department of Neurosurgery, University of Cologne, Germany.
authors: Jasmin
authors: J
authors: Last
authors: Department of Neurosurgery, University of Cologne, Germany.
authors: Moritz
authors: M
authors: Perrech
authors: Department of Neurosurgery, University of Cologne, Germany.
authors: Cemile
authors: C
authors: Denizci
authors: Department of Neuroradiology, University of Cologne, Germany.
authors: Franziska
authors: F
authors: Dorn
authors: Division Neuropsychology, Department of Neurology, University of Cologne, Germany.
authors: Josef
authors: J
authors: Kessler
authors: Department of Neurosurgery, University of Cologne, Germany.
authors: Matthias
authors: M
authors: Seibl-Leven
authors: Department of Neurosurgery, University of Cologne, Germany.
authors: Michael
authors: M
authors: Reiner
authors: Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne, Germany.
authors: Maximilian I
authors: MI
authors: Ruge
authors: Department of Neurosurgery, University of Cologne, Germany.
authors: Roland H
authors: RH
authors: Goldbrunner
authors: Department of Neurosurgery, University of Cologne, Germany. Electronic address: Stefan.grau@uk-koeln.de.
authors: Stefan
authors: S
authors: Grau
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D020146:Putaminal Hemorrhage / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life / Q000523:psychology*; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
keywords: Putaminal hemorrhage; QOL; clot removal; long-term follow-up; outcome; surgery