Ms Karen Twyford1, Ms Jodie Mazzucchelli1, Ms Melina Argyle1, Ms Tara Sharp1, Ms Ann Townley1
1Perth Children's Hospital, Perth, Australia
Biography:
Karen, Jodie, Tara, Melina and Ann all work collaboratively at Perth Children's Hospital in the Kids Rehab department as members of the Acquired Brain Injury team. This team works in the acute setting to provide interprofessional treatment for infants, children and young people with acquired brain injuries.
Abstract:
We detail the role of a carefully coordinated interprofessional approach providing vital support to a patient with Syndrome of the trephined’ (SoT), and her family, during a prolonged inpatient admission.
Our case involves a typically developing 16-year-old patient with no previous health concerns who was admitted to an acute metropolitan paediatric hospital with an intracranial bleed resulting from an arteriovenous malformation. Her rehabilitation was significantly hampered by infection and repeat craniectomies, and positioning requirements including Trendelenburg. Unable to complete traditional rehabilitation, multidisciplinary interventions were coordinated and implemented consistently providing a cohesive personalised approach for this complex patient.
Rehabilitating young people following neurosurgery can be challenging, particularly when ‘Syndrome of the trephined’ (SoT) occurs. SoT is a rare complication post craniectomy involving neurological deterioration and debilitating symptoms, which impact rehabilitation attempts. Rehabilitation is traditionally indicated following cranioplasty.
The young patient’s motivation and capacity to engage in rehabilitation was maintained even when her ability to actively participate was severely compromised due to positioning/mobility limitations, and chronic pain. The team’s responsive and creative approaches provided consistent access and crucial support for both the patient and her family, maximising her functional capacity as measured on the WeeFIM.
What seemed impossible, became possible. Carefully implemented trauma-informed teamwork which focuses on holding a family when traditional rehabilitation isn’t appropriate is essential for long term patient outcomes. A coordinated interprofessional allied health approach maximising rehabilitation opportunities following neurosurgery supports both patient and family adjustment through extended and traumatic hospital admissions.