COMPREHENSIVE REHABILITATION OF PATIENTS AFTER REMOVAL OF A POSTERIOR CRANIAL FOSSA TUMOR
Keywords:
posterior cranial fossa tumors, neurorehabilitation, cerebellar ataxia, cerebellar mutism, dysphagia, dysarthria, functional independence, quality of life, multidisciplinary approach.Abstract
Tumors of the posterior cranial fossa are among the most complex neuro-oncological diseases, as they are located in an anatomically confined space in close proximity to the cerebellum, brainstem, fourth ventricle, caudal group of cranial nerves and cerebrospinal fluid pathways. Even after technically successful surgical removal of the tumor, a significant proportion of patients retain coordination, motor, speech, bulbar, cognitive and psychoemotional disorders. The aim of the article is to provide a scientific rationale for comprehensive rehabilitation of patients after removal of posterior cranial fossa tumors, taking into account the early postoperative period, the structure of neurological deficit and functional prognosis. The article discusses the main components of neurorehabilitation: early verticalization, therapeutic physical training, vestibulo-coordination exercises, speech therapy correction, dysphagia therapy, neuropsychological support and occupational therapy. Special attention is paid to the assessment of recovery using the SARA, Berg Balance Scale, Barthel Index/FIM, MoCA and SF-36. It is shown that comprehensive rehabilitation contributes to the improvement of balance, gait, self-care, speech activity, swallowing, cognitive productivity and quality of life; however, in cases of severe posterior fossa syndrome, cerebellar mutism, brainstem involvement and aggressive oncological treatment, full recovery is not always achieved. It is concluded that the effectiveness of treatment of patients with posterior cranial fossa tumors is determined not only by the radicality of resection but also by the quality of subsequent staged neurorehabilitation.
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