Author

Lucas Keller

Date of Award

5-2020

Document Type

Thesis

First Advisor

Meridee Danks

Keywords

Primary brain tumors, post-craniotomy, Meningiomas, motor dysfunction, cranial nerve

Abstract

Background and Purpose. Primary brain tumors will affect 23,890 adults in the US in 2020. Many of these patients will require an intensive care unit (ICU) if resection is the chosen course of treatment. Early mobility has been shown to reduce negative effect of ICU stays in patient ability and long-term outcomes.

Case Description. This report describes the 4-week inpatient physical therapy management of a 69-year-old female who is 6 months post left cerebrovascular accident (CVA) and presented to the ICU with shortness of breath, severe continuous frontal headaches, and a reduction of regained strength from her CVA in her right extremities. Upon further investigation, vasogenic edema caused by a benign parasagittal meningioma was found. The purpose of this article is to describe the physical therapy driven interventions, and the outcomes found in the patient.

Intervention. Interventions included following a post-craniotomy protocol and an early-mobility protocol which for this patient focused on upright self-supported sitting and gross movement motion. The patient was also educated and trained on bed mobility and posture correction.

Outcomes. Following physical therapy intervention, the patient displayed an increase in right extremity strength and range of motion, increase in independence in bed mobility and sitting balance, and decreases in overall symptoms.

Discussion. Rationale for treatment pre and post-surgery was based on study findings and clinical reasoning from clinical instructors on reducing ICU acquired weakness and strengthening muscle weakness. Treatments were progressed with patient response and clinical findings. The case was not without limitations, these were reflected upon.

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