Neuropsychological assessments in patients with aneurysmal subarachnoid hemorrhage, perimesencephalic SAH, and incidental aneurysms
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Neuropsychological assessments in patients with aneurysmal subarachnoid hemorrhage, perimesencephalic SAH, and incidental aneurysms. / Krajewski, Kara; Dombek, Susanne; Martens, Tobias; Köppen, Johannes; Westphal, Manfred; Regelsberger, Jan.
In: NEUROSURG REV, Vol. 37, No. 1, 2014, p. 55-62.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Neuropsychological assessments in patients with aneurysmal subarachnoid hemorrhage, perimesencephalic SAH, and incidental aneurysms
AU - Krajewski, Kara
AU - Dombek, Susanne
AU - Martens, Tobias
AU - Köppen, Johannes
AU - Westphal, Manfred
AU - Regelsberger, Jan
PY - 2014
Y1 - 2014
N2 - Subarachnoid hemorrhage (SAH) is known to be associated with long-term cognitive deficits. Neurosurgical manipulation on the brain itself has been reported to have influence on neuropsychological sequelae. The following is a comparative study on perimesencephalic and aneurysmal subarachnoid hemorrhage patients as well as elective aneurysm patients that was carried out to determine the isolated and combined impact of surgical manipulation and hemorrhage, respectively, on long-term neuropsychological outcome. Inclusion criteria were good neurological recovery at discharge (modified Rankin Scale 0 or 1) without focal neurological deficit. Standardized psychological testing covered attention, memory, executive functions, and mood. Thirteen aneurysmal SAH patients, 15 patients undergoing elective clipping, and 14 patients with perimesencephalic SAH were analyzed. Standardized neuropsychological testing and social/professional history questionnaires were performed 2 years (mean) after discharge. Memory impairment and slower cognitive processing were found in the aneurysmal and perimesencephalic SAH groups, while elective aneurysm patients showed signs of impaired attention. However, compared with norm data for age-matched healthy controls, all groups showed no significant test results. In contrast, signs of clinical depression were seen in 9/42 patients, 45 % of all patients complained of stress disorders and 55 % of patients were unable to work in their previous professions. Nearly normal neuropsychological test results on long-term follow-up in SAH patients were unexpected. However, a 50 % rate of unemployment accompanied with stress disorders and depression manifests insufficient social and workplace reintegration. Therefore, even more specific rehabilitation programs are required following inpatient treatment to attain full recovery.
AB - Subarachnoid hemorrhage (SAH) is known to be associated with long-term cognitive deficits. Neurosurgical manipulation on the brain itself has been reported to have influence on neuropsychological sequelae. The following is a comparative study on perimesencephalic and aneurysmal subarachnoid hemorrhage patients as well as elective aneurysm patients that was carried out to determine the isolated and combined impact of surgical manipulation and hemorrhage, respectively, on long-term neuropsychological outcome. Inclusion criteria were good neurological recovery at discharge (modified Rankin Scale 0 or 1) without focal neurological deficit. Standardized psychological testing covered attention, memory, executive functions, and mood. Thirteen aneurysmal SAH patients, 15 patients undergoing elective clipping, and 14 patients with perimesencephalic SAH were analyzed. Standardized neuropsychological testing and social/professional history questionnaires were performed 2 years (mean) after discharge. Memory impairment and slower cognitive processing were found in the aneurysmal and perimesencephalic SAH groups, while elective aneurysm patients showed signs of impaired attention. However, compared with norm data for age-matched healthy controls, all groups showed no significant test results. In contrast, signs of clinical depression were seen in 9/42 patients, 45 % of all patients complained of stress disorders and 55 % of patients were unable to work in their previous professions. Nearly normal neuropsychological test results on long-term follow-up in SAH patients were unexpected. However, a 50 % rate of unemployment accompanied with stress disorders and depression manifests insufficient social and workplace reintegration. Therefore, even more specific rehabilitation programs are required following inpatient treatment to attain full recovery.
KW - Adult
KW - Affect
KW - Aged
KW - Attention
KW - Cognition Disorders
KW - Female
KW - Humans
KW - Intracranial Aneurysm
KW - Male
KW - Memory Disorders
KW - Mesencephalon
KW - Middle Aged
KW - Nervous System Diseases
KW - Neuropsychological Tests
KW - Neurosurgical Procedures
KW - Psychomotor Performance
KW - Socioeconomic Factors
KW - Subarachnoid Hemorrhage
KW - Trail Making Test
KW - Treatment Outcome
KW - Verbal Learning
KW - Wechsler Scales
U2 - 10.1007/s10143-013-0489-3
DO - 10.1007/s10143-013-0489-3
M3 - SCORING: Journal article
C2 - 23949148
VL - 37
SP - 55
EP - 62
JO - NEUROSURG REV
JF - NEUROSURG REV
SN - 0344-5607
IS - 1
ER -