Rehabilitation Duration After Chronic Subdural Hematoma Surgery

Q: Rehabilitation Duration After Chronic Subdural Hematoma Surgery

Hello： Whether chronic subdural hematoma requires rehabilitation treatment should primarily depend on clinical symptoms. <br>You may consult your rehabilitation physician for an evaluation and discussion. <br>Wishing you a speedy recovery. <br>The Ministry of Health and Welfare C

The rehabilitation time after surgery for chronic subdural hematoma can vary depending on the individual patient's condition, the extent of the surgery, and any underlying health issues. Generally, patients may require several weeks to a few months of rehabilitation to regain strength and function. It is essential to follow the healthcare provider's recommendations and undergo a tailored rehabilitation program to ensure optimal recovery?

Hello Doctor, my father (78 years old) suffered a head injury in mid-March.
Due to his use of anticoagulants, he experienced headaches, dizziness, and speech difficulties by the end of March, leading to an emergency visit where he was diagnosed with chronic subdural hematoma.
After undergoing minimally invasive surgery, the blood clot was successfully removed.
However, after discharge, he developed the following symptoms: 1.
Aphasia (he can understand but struggles to respond, only able to use simple phrases).
2.
Dysgraphia, with difficulty recognizing numbers and dates.
3.
Hypersomnia (sometimes experiences insomnia at night).
4.
Memory issues.
A CT scan was performed again on April 12, and after a follow-up on April 22, the attending physician deemed the surgery very successful, with no blood clot visible on the imaging.
His language and writing issues had improved to about 80-90% by the end of April.
However, the sleep problems still seem to trouble my father.
Initially, we thought it was a side effect of the antiepileptic medication (Levetiracetam), but after discussing with the physician, we agreed to discontinue the medication on April 22.
Nevertheless, the sleep issues appear to persist (perhaps the discontinuation period is still too short).
I would like to ask how long the rehabilitation period generally lasts after surgery for chronic subdural hematoma? After our follow-up on April 22 (one month later), the attending physician did not schedule another follow-up appointment, which seems to indicate that the case is closed.
From articles I found online, it seems that recovery can occur shortly after surgery, but my father appears to require a longer rehabilitation period.
Thank you!

Chase, 40~49 year old female. Ask Date: 2022/04/27

Dr. Zhao Shaoqing reply Neurosurgery

Hello: Whether chronic subdural hematoma requires rehabilitation treatment should primarily depend on clinical symptoms.
You may consult your rehabilitation physician for an evaluation and discussion.
Wishing you a speedy recovery.
The Ministry of Health and Welfare Changhua Hospital cares about you.

Reply Date: 2022/04/27

More Info

After undergoing surgery for chronic subdural hematoma (CSDH), it is essential to understand the rehabilitation process and the expected duration of recovery. CSDH is a condition that often occurs in older adults, especially those on anticoagulant therapy, and can lead to significant neurological deficits if not treated promptly. Your father's case, involving symptoms such as aphasia, writing difficulties, hypersomnia, and memory issues, is not uncommon following such a procedure.

Understanding Recovery Duration
The recovery period after CSDH surgery can vary significantly among individuals, influenced by factors such as age, overall health, the extent of the hematoma, and pre-existing medical conditions. Generally, the initial recovery from the surgery itself may take a few weeks, but full rehabilitation can extend over several months.
In your father's case, it is encouraging that his imaging studies show no residual hematoma, indicating that the surgical intervention was successful. However, neurological symptoms such as aphasia and cognitive difficulties can persist for a longer duration. These symptoms are often due to the brain's adjustment to the removal of the hematoma and the potential damage that may have occurred prior to surgery.

Rehabilitation Needs
1. Speech and Language Therapy: Given your father's aphasia and writing difficulties, engaging a speech-language pathologist (SLP) is crucial. SLPs can provide targeted exercises and strategies to improve communication skills and cognitive functions related to language. Recovery in language abilities can take time, and consistent therapy can significantly aid in regaining lost skills.

2. Cognitive Rehabilitation: Cognitive deficits, such as memory issues and difficulties with recognizing numbers and dates, may benefit from cognitive rehabilitation therapy. This type of therapy focuses on improving cognitive functions through structured activities and exercises.

3. Sleep Management: Sleep disturbances are common after neurological events. While the cessation of anticonvulsant medication may help, it can take time for the body to adjust. Discussing sleep hygiene practices and possibly consulting a sleep specialist may be beneficial if sleep issues persist.

4. Monitoring and Follow-Up: Although your father's primary physician has not scheduled a follow-up appointment, it is essential to maintain communication with healthcare providers. If symptoms such as sleep disturbances or cognitive issues do not improve, a follow-up visit should be arranged. This could involve reassessing his condition and possibly adjusting his rehabilitation plan.

Timeline for Recovery
While some individuals may experience significant recovery within weeks, others may require several months of rehabilitation. It is not unusual for older adults to need extended periods for full recovery, particularly when cognitive functions are involved. A general guideline suggests that noticeable improvements can be seen within three to six months post-surgery, but complete recovery may take longer.

Conclusion
In summary, your father's recovery from chronic subdural hematoma surgery will likely require ongoing rehabilitation efforts, particularly in speech and cognitive areas. While the surgical outcome appears favorable, the neurological symptoms he is experiencing may necessitate a structured rehabilitation plan. Regular communication with healthcare providers and possibly seeking additional specialists will be key in ensuring he receives the support needed for optimal recovery. It is important to remain patient and proactive in seeking the necessary therapies to aid in his rehabilitation journey.

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