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Brain tumours can be defined as any abnormal growth of cells that produces swelling in the area where they are growing. In the case of brain tumours, this is caused by the pathological growth of the various types of cells that form the tissues in the meninges (the membranes surrounding the brain), in blood vessels or in the cells of nerve tissue (neurons, astrocytes, oligodendrocytes). The symptoms occurring are due to:

  • Increased brain volume: as the cranial cavity cannot expand, the presence of pathological masses causes an increase in intracranial pressure, producing headaches, vomiting, high blood pressure, slow heart rate and in advanced cases, a reduced level of consciousness.
  • Location: symptoms will include visual disturbance if the tumour is located in the part of the brain that deals with vision, limb movement will be affected if the growth is located in the area responsible for movement, and so on. 

Malignant tumours are typically fast-growing, have a good blood supply and do not respond easily to treatment. Benign tumours are slower-growing and the prognosis is good once the growth has been removed. 

Because of the tumour and the after-effects of surgery, treatment with drugs or radiotherapy, patients recovering from brain tumours may experience loss of limb mobility, sensory disorders, lack of coordination, difficulty in walking, cognitive deficit (memory, general awareness, learning), problems with communication (aphasia, dysarthria), emotional problems and behaviour disorders. Vegetative state and minimum response situations are less common. 

Dealing with these symptoms requires a coordinated approach by physiotherapists, occupational therapists, speech therapists and neuropsychologists, all of which can be provided at the CASAVERDE NEUROLOGICAL REHABILITATION CENTRE.

Rehabilitation treatment

The treatment programme is based on neuro-rehabilitation techniques adapted to suit each patient's individual circumstances and aimed at enabling them to recover as fully as possible.  The rehabilitation team meets regularly to set shared objectives and exchange useful information, ensuring excellent quality treatment. Below is a general description of the activities carried out by each of the medical specialities involved in the rehabilitation of people with neurological injuries: 

Medical assessment: The Neurology Consultant and the Rehabilitation Consultant carry out an initial assessment and analysis of the reports compiled by the physiotherapy, occupational therapy, speech therapy and neuropsychology units. 

This initial assessment is regularly reviewed and the treatment programmes implemented by the various units are continued or changed depending on the patient's progress.

Physiotherapy Unit

Initial assessment:

  • Assessing the range of movement in the affected joint
  • Muscle balance
  • Modified Ashworth Scale (MAS) for assessing spasticity
  • Tinetti Assessment Tool
  • Berg Balance Scale (BBS)
  • Sensitivity assessment

 Planning and implementing treatment:

    • Preventing damage associated with the neurological injury
    • Treatment for deterioration in muscle tone 
    • Improving posture control
    • Improving balance
    • Treating problems with walking
    • Treating for pain
    • Aquatic physiotherapy
    • Giving relatives advice on the proper way to handle the patient

Monitoring and progress:

  • Progress is assessed regularly to review treatment objectives. When the highest possible degree of mobility has been recovered, doctors will suggest the patient is discharged.

Occupational Therapy Unit

Initial assessment:

  • Chessington Occupational Therapy Neurological Assessment Battery (COTNAB)
  • Loewenstein Occupational Therapy Cognitive Assessment (LOTCA)
  •  Motor Assessment Scale (MAS)
  • Sensitivity assessment
  • FIM + FAM (Functional Independence Measure + Functional Assessment Scale)
  • The Barthel Index

 Planning and implementing treatment:

  • Treatment for impaired skills following the neurological injury
  • Improving functionality of affected upper limbs
  • Increasing independence in everyday activities and tasks
  • Adapting the patient's environment
  • Recommending technical aids
  • Advice for families
  • Vocational guidance / Rejoining the workplace

 Monitoring and progress:

  • Progress is assessed regularly to review treatment objectives. When the highest possible degree of functionality has been recovered, doctors will suggest the patient is discharged.

Speech Therapy Unit

Initial assessment

  • The Boston Diagnostic Aphasia Examination (BDAE)
  • The Token Test
  • Testing for Dysarthria
  • Short Aphasia screening test
  • Screening for swallowing disorders without bolus
  • Screening for swallowing disorders using the volume-viscosity method of clinical examination

 Planning and implementing treatment:

  • Language retraining
  • Speech retraining
  • Retraining the swallowing reflex
  • Voice therapy
  • Mouth and facial stimulation
  • AAC: Augmentative and/or Alternative Communication

 Monitoring and progress:

  • Progress is assessed regularly to review treatment objectives. When the highest possible degree of recovery has been attained, doctors will recommend the patient is discharged.

Neuropsychology Unit

Initial assessment

  • Clock drawing test
  • Tracing test
  • Hamilton Rating Scale for Depression
  • Hamilton Rating Scale for Depression
  • Integrated neuropsychology screening programme The Barcelona test
  • Wechsler Adult Intelligence Scale WAIS-III
  • Rey Complex Figure Test (RCFT)
  • Complutense Verbal Learning Test for Spain (TAVEC)
  • Benton Visual Retention Test
  • Stroop Colour-Word Test
  • Wisconsin Card Sorting Test (WCST)
  • Rivermead Behavioural Memory Test (RBMT)

 Planning and implementing treatment: 

  • Neurological rehabilitation
  • Behaviour modification
  • Emotional treatment
  • Advice for families

 Monitoring and progress:

  • Progress is assessed regularly to review treatment objectives. When the highest possible degree of recovery has been attained, doctors will recommend the patient is discharged.

Criteria for Admission

Patients with acquired brain damage following:

  • Head injury
  • Acute cerebral haemorrhage
  • Cerebral ischemic anoxia
  • Benign brain tumours
  • Acute Meningitis and encephalitis
  • Aged over 15
  • With recent injuries
  • Showing NO behaviour disorders or aggressive behaviour that may out other residents at risk and/or disturb normal relationships at the centre
  • Showing no signs of infectious or contagious disease
  • Clinically stable

Why come to the Neurological Rehabilitation Unit

  • Because following brain injury, it is vital to receive specialist rehabilitation treatment as early as possible to have the best chance of making a full recovery.
  • Because we believe that every person is unique and we are confident that they can make progress, however slight.
  • Because we have a team of highly qualified professionals who have huge experience in treating these types of injury.
  • Because we have the very latest technical equipment for treating neurological problems: transcranial magnetic stimulator (TMS), ICS balance platform and the AUPA Robot for upper limb rehabilitation, which we designed.
  • Because we train our staff to ensure that care is based on a professional and human approach, catering for the needs of patients and their families.
  • Because even when the patient cannot recover all their lost faculties, we can still work on giving them greater independence by using compensatory strategies.
  • Because we not only treat the patient, we also take into account their family and home life so we can show them how to handle the patient correctly once they are at home. We also provide support and psychological help to enable everyone to adapt to their new situation.
  • Because we give patients and their families information about how to access social assistance and other services they may need.
  • Because all our facilities are specially designed for patient rehabilitation in adapted surroundings where patients and their families can feel at home, rather than in a stereotypical hospital environment. We offer extensive gardens, light and airy facilities, a pleasant temperature all year round, a welcoming atmosphere, countryside location, and much more.

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