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?

ObjectivesTo 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.Patients and methodsThis 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.ResultsTwelve 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.Discussion and conclusionNo 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.

RésuméObjectifsObserver si les patients craniectomisés pour infarctus sylvien malin posent des problèmes médicaux, suivent une évolution des déficits neurologiques ainsi que de la dépendance et ont un mode de sortie différents en comparaison à des patients non craniectomisés habituellement admis en médecine physique et de réadaptation après infarctus sylvien malin ou sévère.Matériel et méthodeÉtude rétrospective comparant des patients craniectomisés pour infarctus sylvien malin à des non craniectomisés, appariés selon l'âge, le côté de la lésion et la période d'hospitalisation.RésultatsDouze craniectomisés (43 ± 10,44 ans) ont été appariés à 12 non craniectomisés (49 ± 7,66 ans). Les deux groupes étaient comparables en terme d'évènements médicaux indésirables généraux. Les évènements propres à la craniectomie sont décrits. L'évolution des déficiences, la durée moyenne de séjour (194 ± 118,93 jours vs 152 ± 94,64 jours), la mesure d'indépendance fonctionnelle de sortie (87 ± 21,28 vs 95 ± 22,19) et le nombre de retours directs à domicile (7 vs 9) étaient comparables.Discussion et conclusionLes patients craniectomisés n'ont pas posé plus de problèmes médicaux, hormis les évènements liés à la craniectomie qui ont pu allonger la durée de séjour sans retentissement majeur.