Abstract Details

Title Neuropsychological Evaluation in Patients Submitted to Cranioplasty: A Case Series

Topic Critical Care/Emergency Neurology/Trauma

Presentation(s) S07 - (-)

Poster/Presentation
Number 006

Background Decompressive craniectomy is an emergency procedure performed to reduce intracranial hypertension. Later, a cranioplasty is performed in order to repair the skull defect. Generally, these patients are in rehabilitation program and the "aim" to put the bone back is considered merely as a cosmetic or a safety procedure. Although, neurological syndroms in patients with large bone defects can develop well described neurological syndromes, few studies adress the cognitive and other behavior effects of the surgery in a prospective view.

Objective

Design/Methods We describe the pre and postoperative neuropsycological evaluation of 8 patients undergoing to cranioplasty. All patients had large bone defects secondary to decompressive craniotomy performed due to brain injury or ischemic stroke. The evaluation consisted of a structured interview and assessment of the Mini-Mental Status Exam (MMSE), neuropsychological tests, a stress inventory (Lipp's Inventory of Stress Symptoms), a depression scale questionnaire (Beck Depression Inventory) and a quality of life questionaire (36-SF). The study was aproved by the local Ethics Committee and all patients had informed consent.

Results The post-cranioplasty findings showed an average increase of two points on the MMSE, five points on the emotional aspects and nine points for activities of daily living. The cognitive findings depicted improvement in memory function (7), aspects ability of information processing speed (4) and inibitory control (5), language function (2) and visuo-constructive ability (1). No quantitative improvements were seen in attention.

Conclusions The repair of the cranial defect suggests a clear benefit to the patients in terms of neurological improvement in many cognitive domains as well as in quality of life. Health professionals involved in the rehabilitation process should be aware of these potential benefits after cranioplasty.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Laura J. Balcer, MD, MSCE, FAAN (NYU Grossman School of Medicine)	Dr. Balcer has received personal compensation for serving as an employee of North American Neuro-Ophthalmology Society. An immediate family member of Dr. Balcer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Children's Hospital of Philadelphia.
	No disclosure on file
	No disclosure on file
	No disclosure on file
David C. Squillacote, MD (David Squillacote MD)	No disclosure on file
	No disclosure on file
Renato Anghinah, MD, FAAN (University of Sao Paulo)	Dr. Anghinah has nothing to disclose.

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