REHABILITATION PROBLEMS AFTER CARDIAC ARREST
Asa Lundgren-Nilsson, Katharina Stibrant Sunnerhagen (Department of Rehabilitation Medicine, Goeteborg University, Sweden)
AIM: To evaluate brain function in survivors of out of hospital cardiac arrests, and its effects on daily life.
MATERIAL: Since April 1996, we have consecutively included patients (18-75 years), who were admitted to any of the hospitals in the City of Goeterborg (500 000 inhabitants).
METHOD: Examinations occur within 14 days, at 45 days, at 3 months and 12 months after the incident. The brain is evaluated twice with MR and once with CBF. NIH stroke scale is used, MMT to detect dementia, NHP to evaluate quality of life. P-ADL and I-ADL is assessed with FIM and IAM.
RESULTS: Fifteen patients have been included, 1 declined follow Up. NIH stroke scale predicted poor prognosis, ie high scores in those who passed away (4 within 45 days). A high score on MMT is predicting high scores on FIM and IAM, and vice versa. The NHP results are not yet evaluated.
CONCLUSIONS: There seem to be a risk for higher cortical dysfunction after cardiac arrest which influences the survivors capacity for a independent living. Inclusions are continuing and with the larger material more information will be available.
The role of the evaluation of the neuropshychological state for the neurological rehabilitation in patients after cardiac surgery.
Gustov A., Alexandrova E., Melnicova T.
Department of Neurology, Medical Academy, N.Novgorod, 603005, Russia.
The dynamic of neuropshychological state in 80 adult patients undergoing coronary artery bypass grafting and cardiac valve replacement before and within 3 weeks after the operation was studied using classic method by A. Luria. The difficulties in the fulfillment of some tests were found. The most informative tests were: the tests on spatial and dynamic praxis; the estimation of rhythmical groups; the reproduction of pictures and geometrical figures; the serial calculation and memory testing. The higher brain functions was restore in 30% of the patients. In the others the neuropshyhological disorders were occurred within 3 weeks after the operation. There was found a correlation between the level of neuropshychological disturbances and the stage of cardiac insufficiency, the age of patients and the cardiopulmonary bypass time. The results of the evaluation of the dynamic of the higher brain functions were used for the early and differentiated neurological rehabilitation of the patients after cardiac surgery.