From Shunt to Recovery: A Multidisciplinary Approach to Hydrocephalus Treatment in Severe Acquired Brain Injury Rehabilitation
Background: Hydrocephalus among Severe Acquired Brain Injury (SABI) patients remains overlooked during rehabilitation. Methods: A retrospective cohort study was carried out of traumatic and non-traumatic SABI patients with hydrocephalus, consecutively admitted over 9 years in a tertiary referral spe...
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| Format: | Article |
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MDPI AG
2021-12-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/12/1/3 |
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| author | Giovanna B. Castellani Giovanni Miccoli Francesca C. Cava Pamela Salucci Valentina Colombo Elisa Maietti Giorgio Palandri |
| author_facet | Giovanna B. Castellani Giovanni Miccoli Francesca C. Cava Pamela Salucci Valentina Colombo Elisa Maietti Giorgio Palandri |
| author_sort | Giovanna B. Castellani |
| collection | DOAJ |
| description | Background: Hydrocephalus among Severe Acquired Brain Injury (SABI) patients remains overlooked during rehabilitation. Methods: A retrospective cohort study was carried out of traumatic and non-traumatic SABI patients with hydrocephalus, consecutively admitted over 9 years in a tertiary referral specialized rehabilitation hospital. Patients were treated with ventriculoperitoneal shunt before or during inpatient rehabilitation and assessed using the Level of Cognitive Functioning Scale and Disability Rating Scale. Logistic regression models were used to identify predictors of post-surgical complications. Linear regression models were used to investigate predictors of hospital length of stay (LOS), disability, and cognitive function. Results: Of the 82 patients, 15 had post-surgical complications and 16 underwent cranioplasty. Shunt placement complication risk was higher when fixed vs. when programmable pressure valves were used. A total of 56.3% achieved functional improvement at discharge and 88.7% improved in cognitive function; of the 82 patients, 56% were discharged home. In multiple regression analyses, higher disability at discharge was related to cranioplasty and longer LOS, while poorer cognitive function was associated with cranioplasty. Increase in LOS was associated with increasing time to shunt and decreasing age. Conclusions: A significant improvement in cognitive and functional outcomes can be achieved. Cranioplasty increased LOS, and fixed pressure valves were related to poorer outcomes. |
| first_indexed | 2024-03-10T01:49:28Z |
| format | Article |
| id | doaj.art-d169a98200b944b98c990d3a2a75b7c0 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T01:49:28Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-d169a98200b944b98c990d3a2a75b7c02023-11-23T13:08:31ZengMDPI AGBrain Sciences2076-34252021-12-01121310.3390/brainsci12010003From Shunt to Recovery: A Multidisciplinary Approach to Hydrocephalus Treatment in Severe Acquired Brain Injury RehabilitationGiovanna B. Castellani0Giovanni Miccoli1Francesca C. Cava2Pamela Salucci3Valentina Colombo4Elisa Maietti5Giorgio Palandri6Montecatone Rehabilitation Institute, Imola, 40026 Bologna, ItalyDepartment of Neuroscience, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli “Federico II”, 80138 Naples, ItalyMontecatone Rehabilitation Institute, Imola, 40026 Bologna, ItalyMontecatone Rehabilitation Institute, Imola, 40026 Bologna, ItalyMontecatone Rehabilitation Institute, Imola, 40026 Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, 40126 Bologna, ItalyDepartment of Neurosurgery, Institute of Neurological Sciences of Bologna IRCCS, Bellaria Hospital, 40139 Bologna, ItalyBackground: Hydrocephalus among Severe Acquired Brain Injury (SABI) patients remains overlooked during rehabilitation. Methods: A retrospective cohort study was carried out of traumatic and non-traumatic SABI patients with hydrocephalus, consecutively admitted over 9 years in a tertiary referral specialized rehabilitation hospital. Patients were treated with ventriculoperitoneal shunt before or during inpatient rehabilitation and assessed using the Level of Cognitive Functioning Scale and Disability Rating Scale. Logistic regression models were used to identify predictors of post-surgical complications. Linear regression models were used to investigate predictors of hospital length of stay (LOS), disability, and cognitive function. Results: Of the 82 patients, 15 had post-surgical complications and 16 underwent cranioplasty. Shunt placement complication risk was higher when fixed vs. when programmable pressure valves were used. A total of 56.3% achieved functional improvement at discharge and 88.7% improved in cognitive function; of the 82 patients, 56% were discharged home. In multiple regression analyses, higher disability at discharge was related to cranioplasty and longer LOS, while poorer cognitive function was associated with cranioplasty. Increase in LOS was associated with increasing time to shunt and decreasing age. Conclusions: A significant improvement in cognitive and functional outcomes can be achieved. Cranioplasty increased LOS, and fixed pressure valves were related to poorer outcomes.https://www.mdpi.com/2076-3425/12/1/3rehabilitation outcomebrain injurieshydrocephalusventriculoperitoneal shuntcerebrospinal fluid |
| spellingShingle | Giovanna B. Castellani Giovanni Miccoli Francesca C. Cava Pamela Salucci Valentina Colombo Elisa Maietti Giorgio Palandri From Shunt to Recovery: A Multidisciplinary Approach to Hydrocephalus Treatment in Severe Acquired Brain Injury Rehabilitation Brain Sciences rehabilitation outcome brain injuries hydrocephalus ventriculoperitoneal shunt cerebrospinal fluid |
| title | From Shunt to Recovery: A Multidisciplinary Approach to Hydrocephalus Treatment in Severe Acquired Brain Injury Rehabilitation |
| title_full | From Shunt to Recovery: A Multidisciplinary Approach to Hydrocephalus Treatment in Severe Acquired Brain Injury Rehabilitation |
| title_fullStr | From Shunt to Recovery: A Multidisciplinary Approach to Hydrocephalus Treatment in Severe Acquired Brain Injury Rehabilitation |
| title_full_unstemmed | From Shunt to Recovery: A Multidisciplinary Approach to Hydrocephalus Treatment in Severe Acquired Brain Injury Rehabilitation |
| title_short | From Shunt to Recovery: A Multidisciplinary Approach to Hydrocephalus Treatment in Severe Acquired Brain Injury Rehabilitation |
| title_sort | from shunt to recovery a multidisciplinary approach to hydrocephalus treatment in severe acquired brain injury rehabilitation |
| topic | rehabilitation outcome brain injuries hydrocephalus ventriculoperitoneal shunt cerebrospinal fluid |
| url | https://www.mdpi.com/2076-3425/12/1/3 |
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