Functional recovery after rehabilitation for cerebellar stroke

Background ann Purpose-Relatively few data exist concerning functional reco very after ischemic and hemorrhagic cerebellar stroke. We studied patients admitted to a rehabilitation hospital after cerebellar stroke to quantify r ecovery after rehabilitation therapy and to identify variables that predict ed functional outcome. Methods-This study was a retrospective review of consecutive cases admitted in a ii-year period with new cerebellar infarct or hemorrhage. Clinical fe atures of stroke were recorded and comorbidities scored with the Charlson I ndex. Follow-up information was obtained by telephone interview. The Functi onal Independence Measure (FIM) was scored at admission (AFIM), discharge ( DFIM), and follow-up (FFIM). Outcome measures were DFIM and FFIM. Univariat e and multivariate analyses were performed. Results-Fifty-eight cases were identified (mean age 69.2 years; 49 infarcts , 9 hemorrhages). Mean AFIM was 65,5, and mean DFIM was 89.8, Mean AFIM was significantly higher in the infarct than in the hemorrhage subgroup (70 ve rsus 43, P = 0,006). Mean DFIM was also higher in the infarct subgroup but did not reach statistical significance (93 versus 74, P = 0.1). Follow-up i nformation was obtained for 45 cases (78%) (mean interval 19.5 months). Med ian FFIM was 123,5, Outcome was significantly positively correlated with AF IM and initial presenting syndrome of vertigo/vomiting/ ataxia/headache. Ou tcome correlated negatively with preexisting comorbidity score, altered lev el of consciousness at initial presentation, and superior cerebellar artery infarction. On multivariate analysis, AFIM and comorbidity score were inde pendent predictors of outcome. Conclusions-Substantial improvement of mean FIM score frequently occurs aft er rehabilitation after cerebellar infarction. Functional outcome is best p redicted by preexisting comorbidities and functional status at the time of discharge from acute hospitalization.