Document Detail

Cognitive deficits in the acute stage after subarachnoid hemorrhage.
MedLine Citation:
PMID:  9802849     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: In spite of fundamentally improved medical management of subarachnoid hemorrhage (SAH), many patients remain mentally impaired. However, the causes of these disturbances are unclear. The present study was performed to elucidate the significance of the hemorrhage itself and related events in the neuropsychological performance of patients in the acute stage after SAH. METHODS: A series of 51 patients were examined, by means of a battery of cognitive tests, 1 to 13 days (mean, 5.9 d) after SAH. Thirty-three patients had experienced ruptured aneurysms, and 18 had sustained SAH of unknown origin. Furthermore, 25 patients who had undergone surgical treatment (a mean of 5.0 d earlier) of prolapsed lumbar discs served as a control group. RESULTS: The cognitive deficits of the patients after aneurysmal SAH proved to be comparable to those after spontaneous SAH of unknown origin, with the single exception of a significantly worse (P = 0.003) concentration capacity in the surgically treated group. The severity of SAH in computed tomographic scans correlated (up to r = 0.57, P < 0.001) with poor performance on tests of memory, concentration, divided attention, and perseveration. Frontal intracerebral hemorrhage led to significantly more errors in an aphasia screening test (P < 0.001) and a test of perseveration (P < 0.001). If acute hydrocephalus was present, the patients exhibited worse long-term memory (P < 0.001), showed slower reaction times (P = 0.01), and made more errors in the perseveration test (P = 0.004). Patients with intraventricular blood performed at significantly lower levels in the concentration (P = 0.001), divided attention (P = 0.01), long-term memory (P < 0.001), and perseveration (P = 0.003) tests. CONCLUSION: The results emphasize that the severity of SAH (Fisher score) is the most important factor related to cognitive dysfunction, but frontal hematoma, intraventricular hemorrhage, and acute hydrocephalus were also associated with cognitive deficits, compared with patients with SAH without these findings.
B O Hütter; I Kreitschmann-Andermahr; J M Gilsbach
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  43     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1999-02-11     Completed Date:  1999-02-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1054-65     Citation Subset:  IM    
Department of Neurosurgery, University of Technology, Rheinisch-Westfalische Technische Hochschule Aachen, Germany.
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MeSH Terms
Aneurysm, Ruptured / complications,  diagnosis
Aphasia / diagnosis
Brain Damage, Chronic / diagnosis*
Cognition Disorders / diagnosis*
Hydrocephalus / complications,  diagnosis
Intracranial Aneurysm / complications,  diagnosis
Middle Aged
Neurologic Examination
Neuropsychological Tests*
Subarachnoid Hemorrhage / complications*
Tomography, X-Ray Computed

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