London, United Kingdom 2013 Intracerebral/subarachnoid haemorrhage and venous diseases (PO 856 - 890 ) Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 799 855 Rehabilitation and reorganisation after stroke THE BENEFITS OF EARLY REHABILITATION IN PATIENTS WITH CEREBRAL STROKE E.I. Batishcheva1 Belgorod State University; St. Ioasaf Regional Clinical Hospital,, Belgorod, RUSSIAN FED-ERATION1 A stroke often leaves a heavy consequences in the form of motor, visual, speech and mental disor-ders, causing a significant exclusion of patients in society. The problem of medical rehabilitation and social adaptation of patients becomes an important task of the government. The aim: assessment of the effectiveness of early rehabilitation of the patients with cerebral stroke. Material and methods. The outcomes of a treatment and rehabilitation measures in 250 patients with acute stroke at the age from 18 to 85 years of age were analysed. 42,8% women and 57,2% men were examined. The period from development of a stroke to the beginning of the rehabilitation was of 3.2±1.2 days. We worked with each of patients individually, having rehabilitation purposes and using the possibilities of a multidisciplinary team. The NIHSS, Rankin Scales, Bartel Index were ap-plied to assess the effectiveness of interventions. Results. Partial, in some cases full recovery of moving function in the proximal department of the limbs, fingers, improvement of walking were achieved in patients with motor deficit, late-tonic dis-orders, destroyed motility of fingers, the difficulty of verticalization and independent walking. The neurological severity of the stroke according to the NIHSS Scale was reduced from 12,3±2,9 on admission to 6,8±1,2 by the 21st day (P<0,05), the functional outcomes of the Rankin Scale was improved from 3.4±0,2 to 2,7±0,1 (P<0,05), Bartel Index was increased with 65±12 up to 80±7 by the 21st day as result of the undertaken measures. The existing cognitive dysfunction, disorders of speech and the presence of post-stroke depression made it difficult to carry out the rehabilitation and reduced its effectiveness. Conclusions. Early rehabilitation measures, implemented by a multidisciplinary team of over a rela-tively short period of time allow to reduce reliably the severity of neurological and functional disor-ders in-apoplexy patients, as well as to adapt them to the existing exposure. 856 Intracerebral/subarachnoid haemorrhage and venous diseases Endovascular treatment of refractory intracranial hypertension following cerebral venous thrombosis B. Rodic1, A. Horst2, Z. Kulcsar3, I. Wanke4, D. Rüfenacht5 Kantonsspital Winterthur, Winterthur, SWITZERLAND1, Kantonsspital Winterthur, Winterthur, SWITZERLAND2, Neuroradiology Hirslanden Zürich, Zurich, SWITZERLAND3, Neuroradiology Hirslanden Zürich, Zurich, SWITZERLAND4, Neuroradiology Hirslanden Zurich, Zurich, SWIT-ZERLAND5 Background: A 21 year old women presented with acute right sided headache, associated with nau-sea, photo- and phonophobia. She had no significant past medical history. Methods: Neurological examination revealed bilateral papilloedema and partial abducens nerve palsy. The prompt investigation by magnetic resonance imaging discovered extended cerebral sinus venous thrombosis on the right side accompanied by stenosis of the transverse venous sinus on the opposite side. The only identified risk factor was oral contraceptive use. Results: Despite progressive recanalization of thrombosed cerebral dural sinuses under oral antico-agulation, the clinical signs of increased intracranial pressure (headache, nause, diplopia and new tinnitus) persisted. The symptoms considered refractory on drug therapy with acetazolamide and repeated lumbar puncture. Conventional cerebral angiography provided a dural arteriovenous fistula (AVF) Cognard Type 2a at partially recanalized right-sided transverse sinus. After repeated endovas-cular interventions with stent placement within a transverse sinus and embolization of the AVF, the patient has reached a nearly asymptomatic condition. Conclusion: Dural arteriovenous fistulas are relatively rare complication of cerebral venous sinus thrombosis which can present a variety of different symptoms ranging from tinnitus to devastating intracranial hemorrhage. Conventional angiography remains the gold standard for diagnosis and planning of therapy of AVF. Endovascular intervention is the first-line treatment of these lesions. Additionally, our case illustrates that the described contralateral “idiopathic” transverse sinus steno-sis on on the day of hospital admission was a result and not a cause of elevated intracranial pressure.
Karger_ESC London_2013
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