[Nutritional assessment for patients with neurosurgical diseases]

There have been few guidelines in the field of nutritional management with regard to neurosurgical patients. In this review, caloric intake and nutritional parameters were measured in 24 patients in the acute stage and 32 patients in the chronic stage (prolonged unconscious state). We ascertained (1) whether the caloric intake was adequate or not, (2) the relationship between the grade of neurological damage and the nutritional assessment, and (3) we discussed the relationship between diseases and the nutritional assessments. The acute-stage patients, 14 male and 13 female, consisted of both a neurologically good prognostic group and a neurologically poor prognostic group. All of the prolonged-unconscious patients revealed poor prognosis. The nutritional assessment was referred to such parameters as, diet and nutrition, anthropometric measurements, laboratory tests, immunological parameters and prognostic nutritional index. The results were, 1) the acute stage patients received less caloric intake than their resting energy expenditure, 2) the neurologically poor prognostic patients showed muscle atrophy and decrease of creatinine-height index which represents muscle content, 3) there was no significant differences between the assessment parameters in each disease, and 4) serum electrolytes decreased in prolonged-unconscious patients with a small amount of caloric intake.