Abstract
Brain tumor location is an important factor determining the functional state after brain tumor surgery. We assessed the functional state and course of rehabilitation of patients undergoing surgery for brain tumors and assessed the location-dependent risk of loss of basic motor skills and the time needed for improvement after surgery. There were 835 patients who underwent operations, and 139 (16.6%) required rehabilitation during the inpatient stay. Karnofsky Performance Scale, Barthel Index, and the modified Rankin scale were used to assess functional status, whereas Gait Index was used to assess gait efficiency. Motor skills, overall length of stay (LOS) in hospital, and LOS after surgery were recorded. Patients were classified into four groups: cerebral hemisphere (CH), ventricular system (VS), and cerebellopontine angle (CPA) tumors; and a control group not requiring rehabilitation. VS tumor patients had the lowest scores in all domains compared with the other groups before surgery (p < 0.001). Their performance further deteriorated after surgery and by the day of discharge. They most often required long-lasting postoperative rehabilitation and had the longest LOS (35 days). Operation was most often required for CH tumors (77.7%), and all metrics and LOS parameters were better in these patients (p < 0.001). Patients with CPA tumors had the best outcomes (p < 0.001). Most patients (83.4%) with brain tumors did not require specialized rehabilitation, and LOS after surgery in the control group was on average 5.1 days after surgery. VS tumor patients represent a rehabilitation challenge. Postoperative rehabilitation planning must take the tumor site and preoperative condition into account.
Highlights
Rehabilitation after brain tumor surgery is complex due to the diverse symptoms and neurological sequelae seen in these patients
Eighty patients after cerebral hemisphere (CH) tumor surgery (12.3%) required rehabilitation due to limb paresis or paralysis compared with 26.4% patients after ventricular system (VS) tumor surgery, and only one patient after cerebellopontine angle (CPA) tumor surgery
length of stay (LOS), LOS after surgery, LOS in the Intensive Care Unit (ICU), the time needed for rehabilitation, and the time needed to improve the loss of basic motor skills after surgery
Summary
Rehabilitation after brain tumor surgery is complex due to the diverse symptoms and neurological sequelae seen in these patients. Tumor location has a important impact on outcomes [1,2,3,4,5,6,7]. 60% of brain tumors—especially gliomas—are sited in the cerebral hemispheres, over half of which are highly malignant glioblastomas [1,4,6,7,8]. These can cause a constellation of symptoms depending on the affected lobe.
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