Functional recovery in decompressive craniectomized patients with intractable intracranial pressure after severe cerebral lesions

摘要

Decompressive craniectomy (DC) remains a controversial therapeutic strategy in patients with refractory intracranial pressure. The long-term functional recovery and quality of life in a sample of decompressive craniectomized patients admitted to a neuro-rehabilitation setting are reported. The Barthel (BS) and modified Rankin (mRS) scale were administered at admission, discharge and follow-up. The quality of life was evaluated with the SF-36 questionnaire at follow-up (41.1+-16.6 months). Forty (13F, 27M, mean age 46.4+-20.5) patients were enrolled. The mortality rate was 27.5%. The mean Barthel values at admission, discharge and follow-up, resulted 2.7+-5.3; 43+-30 and 77.1+-27.3 (p<0.001), and the median mRS values were 5 (IQR 4-5), 5 (IQR 2-5), and 2 (IQR 1-3), respectively. Seventeen (42.5%) patients gained good recovery and 2 (5%) presented a persistent vegetative state. The SF-36 questionnaire showed significant abnormalities in all domains of health status. Craniectomized patients achieved good long-term outcome, but they experienced significant difficulties in the health status.