P-2-04-05
COGNITIVE IMPAIRMENT IN PATIENTS WITH CHRONIC SUBDURAL HAEMATOMA
Shinichiro Maeshima, Dennis S. Smith (Rehabilitation Studies, University or Sydney & Royal Rehabilitation Centre, Australia), Hirao Yamaga, Mari Nakagawa, Daisuke Naka, Hiroki Nishibayashi, Yasuhiko Nishimura, Kazuo Nakakita, Fuminori Ozaki, Kunio Nakai, Toru Itakura, and Norihiko Komai (Department of Neurological Surgery, Wakayama Medical College, Wakayama, Japan)
The aim of this study was to measure improvement in cognitive function after trepanation for chronic subdural haematoma using the event-related evoked potentials (P300). Fourteen patients, 10 males and 4 females, with chronic subdural haematomas (3 right, 7 left, 4 bilateral) were investigated. The patients ranged in age from 40 to 80 years. The P300 was elicited with the auditory oddball paradigm before, 1 week, and 1 month after trepanation. P300 latency was prolonged in 10 patients prior to surgery. In five of these patients the P300 latency revealed to normal 1 week after trepanation. The P300 latency did shorten but was still prolonged in the other patients. Of these three patients, the latency returned to normal three months after trepanation. We conclude that the P300 interval is a useful objective measure for evaluation of the effect of treatment in chronic subdural haematoma.
P-2-04-06
FUNCTIONAL OUTCOMES FOLLOWING THALAMIC HAEMORRHAGE: RELATIONSHIP BETWEEN MOTOR AND COGNITIVE FUNCTIONS AND ADL
Shinichiro Maeshima, George Truman, Dennis S. Smith (Rehabilitation Studies, University of Sydney & Royal Rehabilitation Centre, Australia), Nobuyuki Dohi, (Hiroshima Prefectual College of Health Science and Welfare), Toru Itakura, Norihiko Komai (Wakayama Medical College, Japan)
We examined twenty-two patients with thalamic haemorrhage to investigate the relationship between motor and cognitive function, and activities of daily living (ADL) which is assessed by the Barthel index (BI).
Motor paresis was found in all patients, visual field defect in 8, and sensory impairment in 21. Aphasia was found in 5 of the 9 patients with left thalamic haemorrhage. Unilateral spatial neglect was found in 10 of the 13 patients and anosognosia in 3 of the 13 patients with right thalamic haemorrhage.
Patients with unilateral spatial neglect had lower BI scores on admission than patients without unilateral spatial neglect (Mean: 17.0 and 24.6, respectively; F=4.38, df: 1, p< .05). Patients with aphasia on admission had lower ADL at discharge than patients without aphasia on admission (Mean: 57.0 and 84.7, respectively; F=7.70, df=l, p< .05). There was a significant difference between the severity of paresis in upper and lower limb and ADL at discharge. The two-way repeated measures ANOVA showed a significant difference between severity of paresis in lower limb and ADL improvement.
We suggest that the most important predictor of outcome interms of ADL was paresis in lower limb, and not aphasia nor unilateral spatial neglect.
