Subarachnoid haemorrhage (SAH): long-term cognitive outcome in patients treated with surgical clipping or endovascular coiling

Abstract

Study findings indicate fewer cognitive deficits following endovascular coiling. Cognitive deficits in the clipped group may be due in part to the invasive nature of neurosurgical clipping. Further prospective research with regard to long-term cognitive and emotional outcomes is warranted. IMPLICATIONS OF REHABILITATION: • Treatment of ruptured intracranial aneurysms by either endovascualar coiling or neurosurgical clipping can result in significant long-term physical disability as well as cognitive impairment. • Observed cognitive impairment(s) tend to be less in patients following endovascular coiling. • Following ruptured aneurysm, patients with cognitive impairment report reduced health related quality of life and increased anxiety. • Those with identified cognitive impairment(s) may benefit from cognitive remediation.

Effect of thyroid hormone replacement therapy on cognition in long-term survivors of aneurysmal subarachnoid hemorrhage

“…The patients provided written consent and comprehensive neuropsychological test. Both treatment groups exhibited cognitive impairments in memory, attention and speed of information processing (4). Previous clinical studies have indicated that long-term survivors of aSAH frequently exhibit hypothyroidism (5,6).…”

Treatment of spontaneous subarachnoid hemorrhage and self-reported neuropsychological performance at 6 months – results of a prospective clinical pilot study on good-grade patients

“…Given the study biases, there is an ongoing controversy in the literature, whether (7,25,28,34,91,105) or not (7,29,55,91,99,103) coiling is preferable over surgical clipping with regard to a favorable functional and cognitive outcome. To date, only 13 SAH studies (7,24,26,28,29,34,55,58,59,89,91,99,112) have directly compared the effects of clipping and coiling on cognitive outcome, and, from those, merely two research groups (29,55) provided information on the time course of neurobehavioral impairment after aSAH. Due to the limited number of studies available addressing this issue, no final conclusion can yet be drawn.…”

Long-Term Cognitive Deficits After Subarachnoid Hemorrhage in Rats

“…Patients may experience a broad range of deficits involving memory, learning, attention, psychomotor speed, and emotional health [3][4][5]. Short-term rodent recovery models are often used to explore post-SAH mechanisms that result in neurologic deficits [6][7][8].…”