Spinal cord high grade astrocytoma

ABSTRACT

OBJECTIVES: To describe the medical history, psychosocial aspects and the rehabilitation management of a patient with a high-grade astrocytoma of the spinal cord. To review the literature regarding the epidemiology, classification, treatment, prognosis, and outcomes of astrocytomas involving the spinal cord. To discuss issues and controversies in the rehabilitation management of spinal cord high-grade astrocytomas. SETTING: Inpatient Spinal Cord Injury Rehabilitation Unit of Veterans Affair Medical Center; San Juan, Puerto Rico. MAIN OUTCOME MEASURES: Survival time and Functional Independence Measure (FIM) prior to and after receiving comprehensive intensive inpatient rehabilitation treatment. RESULTS: Aggressive multimodality treatment including acute inpatient interdisciplinary rehabilitation approach provided excellent results exceeding survival time and functional expectations for a patientwith high-grade astrocytoma. CONCLUSIONS: This case report stands out for two main reasons (1) the survival time of more than three years, which exceeded the expected survival time of ten months for a patient diagnosed with spinal cord high grade astrocytoma and (2) for the outcomes achieved through an intensive comprehensive acute inpatient interdisci-plinary rehabilitation program which helped the patient achieve previous premorbid functional goals. Further studies are needed to compare these outcomes versus the ones that can be achieved through the implementation of rehabilitation management and care programs in long term care facilities such as nursing homes and hospice among others.