Neurological Impairment due to a Large Skull Defect: Implications for Neurorehabilitation

Abstract

In the classical descriptions patients who exhibit this type of signs and symptoms, do so after an initial period of improvement following the decompressive surgery. Thereafter as the scalp flap sinks there is a AbstractGiven the continued use of decompressive craniectomy in the management of neurological emergencies recognition of complications is important in order for patients to gain maximal benefit during rehabilitation. One complication that has received relatively little attention is the neurological dysfunction that can occur due to distortion of the brain under the scalp as cerebral oedema subsides.The neurological deterioration that can occur can take many forms and this is probably due to a multifactorial pathophysiology. Recognition of this condition is important if delays in the rehabilitation process are to be avoided. This review discusses the historical background, possible pathophysiological mechanisms, clinical incidence and implications for healthcare workers involved in neurorehabilitation.Neurological Impairment due to a Large Skull Defect: Implications for Neurorehabilitation Stephen HoneybulDepartment of Neurosurgery, Sir Charles Gairdner Hospital and Royal Perth Hospital, Western Australia In te rna tion a l J o u rn al of Ne u r o re h abi litat io n