Is there a difference in cognitive deficits after aneurysmal subarachnoid haemorrhage and subarachnoid haemorrhage of unknown origin?

Abstract

In a retrospective follow-up study 38 patients with aneurysmal subarachnoid haemorrhage (SAH) and 20 patients without an angiographically proven source of SAH were tested neuropsychologically one to five years after the acute event. All patients were operated on early within 72 hours if an aneurysm was proven angiographically and all were treated with nimodipine. Both patient groups had comparable cognitive deficits in spite of the less severe SAH of non-aneurysmal origin. Only in two cognitive functions the groups differed significantly. The patients after non-aneurysmal SAH had a significantly lower mean in the IQ subtest similarities finding (p < 0.05), while the patients after aneurysmal SAH had a significantly lower mean in a test of visual cognition (p < 0.05). A more detailed analysis with clinically homogeneous subgroups was additionally performed. The results showed in the subgroup with poor clinical grades that patients with aneurysmal SAH were significantly more disturbed in focal cognitive functions like short- and long-term memory and word-finding capacity, while patients with SAH of unknown origin scored significantly worse in a neuropsychological test related to attention, which can be regarded as a more diffuse cognitive function.

Cognitive and emotional consequences of perimesencephalic subarachnoid hemorrhage

“…More complex tests that assess executive functions could not be used, because there is a lack of normative data for the Portuguese population and because performance on these tests is strongly influenced by education level, which was highly variable in our sample. Quality of life was not tients with aneurysmal SAH and patients with SAH of unknown origin [15,17]. Hutter et al [15] demonstrated a relationship between severity of bleeding and cognitive deficit.…”

“…Quality of life was not tients with aneurysmal SAH and patients with SAH of unknown origin [15,17]. Hutter et al [15] demonstrated a relationship between severity of bleeding and cognitive deficit. These authors reported a"diffuse" cognitive damage pattern in patients with SAH of unknown cause, in contrast with"focal" cognitive deficits in aneurysmal SAH patients.…”

Early neuropsychological sequelae of aneurysm surgery and subarachnoid haemorrhage

“…On the other hand, his may be true only in the case of moderate and relatively transient vasospasm measured by TCD. Regarding the overall effect of early aneurysm surgery, two studies reported that patients after aneurysmal SAH and early surgery and patients after SAH of unknown origin present with a comparable degree of neuropsychological impairment [26,53]. Even though surgery itself is associated with cognitive deficits, there is, however, no factual discrepancy to the above mentioned findings.…”

Epidemiology of Traumatic Brain Injury and Subarachnoid Hemorrhage

“…The grade at discharge is a good predictor of impairment of cognition and memory at follow-up assessments. Patients with poor clinical grades with aneurysmal SAH are significantly more disturbed in focal cognitive functions like short-and longterm memory and word-finding capacity than patients with SAH of unknown origin that score significantly worse on neuropsychological tests [42]. Although SAH of unknown etiology represents much less of a catastrophe as compared with hemorrhage of aneurysmal origin, it does not preclude cognitive disturbances.…”