Brain tumor rehabilitation.

Brain and other central nervous system tumors have a very high likelihood of producing long-term disabling effects owing to the tumor itself and the effects of treatment, including surgical complications, neurotoxic effects of radiation, and debility caused by chemotherapy. Even benign or low-grade brain tumors can cause significant disability. Brain tumors occur over the life span, showing progressively higher incidence with advancing age. The common types of primary brain tumor differ between pediatric and adult age groups. Evidence for effectiveness of rehabilitation is favorable. Brain tumor patients treated in acute rehabilitation settings improve comparably with individuals with stroke or traumatic brain injury. Although patients with primary brain tumors have been better studied than those with metastatic disease, significant gains with inpatient rehabilitation have been reported in the latter group also. Outpatient programs to address cognitive deficits in brain tumor survivors, including cognitive therapy and pharmacologic strategies, have found benefit. While the patient is receiving rehabilitation care, physiatrists, in interdisciplinary collaboration with the pertinent oncology-related services, assist with managing symptoms including fatigue, headache, and sleep disturbance and medical complications including depression, seizures, and thromboembolic disease. Better methods are needed to identify patients for rehabilitation services when appropriate over the course of the disease process.