Features of complex therapeutical rehabilitation management with favorable evolution in a patient with right hemiplegia, mixed aphasia and optic atrophy post surgical removal of be-nign intraventricular tumor (central neurocytoma)

Abstract

Central neurocytoma (CN) is a benign brain tumor located intraventricularly and classified as grade II by the World Health Organization in 2000 (classification of tumours of the central nerv-ous system). CN is frequently found in young adults and may increase intracranial pressure causing obstructive hydrocephalus, manifested by neurological symptoms such as headaches and vision problems. CN has a relatively good prognosis, provided a complete surgical resec-tion is performed. Materials and Methods: In this presentation, we describe the case of a 21-year-old patient with a personal history of headache, vomiting and decreased visual acuity in both eyes, who was admitted to the Neurosurgery Clinic III of THEBA. Following clinical and para-clinical assesements, the patient was diagnosed with a left lateral ventricular tumor with exten-sion in the right lateral ventricle and the third ventricle. The neurosurgery team decided a total resection of the tumor would be the best approach in this case. The biopsy report revealed that it was a central neurocytoma. After the surgery the patient’s neurological status improved and she was admitted in the Neuromuscular Rehabilitation CinicalDivision with flaccid right hemi-plegia and mixed aphasia. The patient was functionally assessed using the following scales: Functional Independence Measure (FIM), Montreal Cognitive Assessment (MOCA), modified Ashworth, Penn Spasm Frequency Scale (Penn), Life Quality Assessment (QOL), FAC Interna-tional Scale, Glasgow Outcome Scale-Extended (GOS-E), modified Rankin scale (mRS), Aphasia Screening Test (AST-Whurr). Results: The patient showed a favorable evolution with remitted aphasia and walking traing with self-support in tertrapod walking stick. At the same time, the patient can use the plegic upper limb in performing feeding activities. Conclusion: It should be noted that neurosurgical intervention and pharmacological treatment, associated with an indi-vidual rehabilitation program consisting of: physical, occupational and speech therapies and al-so rehabilitation nursing interventions in a patient diagnosed with flaccid right hemiplegia and mixed aphasia after total surgical resection of the intraventricular central neurocytoma has im-proved the control of symptoms and the patient's quality of life.

Keywords

• benign brain tumor
• central neurocytoma
• hemiplegia
• rehabilitation