Early rehabilitation of higher cortical brain functioning in neurosurgery, humanizing the restoration of human skills after acute brain lesions.

OBJECTIVE

Increasingly more patients after brain damage survive, however, suffering from severe impairments of higher cerebral functioning.

METHODS

Patients after acute brain damage, mainly secondary to TBI, are referred for early neurosurgical rehabilitation. Our concept follows the German Guidelines. It is based on a multidisciplinary team approach. Next-of kin are included in the treatment and caring.

RESULTS

The essential aspect of early neurosurgical rehabilitation is the integration of disciplines and consistent goal setting to regard individual patients' needs. Good structural organization of the team, notice of basic communication rules, conflict management and a definite decision making increase productive interdisciplinary working. The film (shown at the symposium) shows how to humanize human skills after brain damage.

DISCUSSION: Obviously the impairment of mental-cognitive and neurobehavioral functioning and not the loss of physical skills cause the patients' loss of life transactions and final outcome after brain damage. Our concept supports and fosters the individuals' neural plasticity and final social reintegration.

CONCLUSION

Functional rehabilitation is a process whereby patients regain their former abilities or, if full recovery is not possible, achieve their optimum physical, mental, social and vocational capacity. Neurosurgeons will have to work in close collaboration with the neuropsychologist and all other members of the interdisciplinary team day by day.