Prognostic opportunity neurological evaluation scale in patients with non infiltrative paraxial tumors in early period after posterior fossa surgery

Abstract

For optimal airway protection in early postoperative period after fossa posterior surgery (PFS) necessary prognosis of neurological dynamic through neurological exam before operation. We performed Neurological Evaluation Scale (NES). The aim of our study was research possibility NES to predict brain stem deterioration in early postoperative period after PFS It was a prospective study during. It included 182 patients operated for fossa posterior tumors (FPT). Including criteria were age elder 18 years, operation in fossa posterior non infiltrative paraxial tumors. We examined all pts. before and after operation immediately after extubation in ICU. NES provide complex neurological estimation with emphasis of brain stem function. NES points after operation were subtracted from points before operation - AB-criterion (ABc). Positive ABc correspond augmentation neurological impairment. Negative or zero ABc correspond neurological improvement. All neurological symptoms were grouped in 7 NES blocks in conformity their relation with CNS. We divided all pts. in two group by ABc and revealed, that pts with positive ABc has reliability less NES points before operation, than pts. with negative or zero ABc. We found frequency of occurrence of each of the NES blocks in full neurologic status. We reveal more frequency of involvement the caudal stem in pts. with more NES points. We evaluate probability impairment or regression neurological symptoms by ABc with sensitivity 90,7% and specificity 95%. We created prognostic model, which could predict outcome in discharge from clinic in terms on NES blocks in early postoperative period.

Keywords

• взрослые пациенты
• неврология
• нейрохирургия
• интенсивная терапия
• инфратенториальная хирургия
• прогноз
• шкала
• послеоперационный период