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Neurulation is the embryological process which forms the precursors of the central nervous system and occurs after gastrulation has established the three primary cell layers of the embryo: ectoderm, mesoderm, and endoderm. In humans, the majority of this system is formed via primary neurulation, in which the central portion of the ectoderm—originally appearing as a flat sheet of cells—folds upwards and inwards, sealing off to form a hollow neural tube. As development proceeds, the...
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Neurological dysfunction due to large skull defect: Implications for physiotherapists.

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Area of Science:

  • Neurosurgery
  • Neurology
  • Rehabilitation Medicine

Background:

  • Decompressive craniectomy is a critical intervention for neurological emergencies.
  • Complications of this procedure require thorough understanding for optimal patient outcomes.
  • Brain distortion under the scalp following cerebral oedema subsidence is an under-recognized complication.

Purpose of the Study:

  • To review the historical context of brain distortion post-decompressive craniectomy.
  • To explore the pathophysiological mechanisms underlying this neurological dysfunction.
  • To discuss the clinical incidence and implications for rehabilitation professionals.

Main Methods:

  • Literature review of existing studies on decompressive craniectomy complications.
  • Analysis of pathophysiological theories related to brain distortion and oedema resolution.
  • Synthesis of clinical observations and reported incidence rates.

Main Results:

  • Neurological dysfunction can manifest diversely due to multifactorial pathophysiology.
  • Delayed recognition of this complication can impede rehabilitation progress.
  • The review highlights the need for increased awareness among clinicians.

Conclusions:

  • Brain distortion following decompressive craniectomy is a significant complication affecting neurological function.
  • Understanding its pathophysiology is key to timely diagnosis and intervention.
  • Physiotherapists play a crucial role in managing patients experiencing this dysfunction during rehabilitation.