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

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Summary

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 aneursym 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 homogenous 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.

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References

  1. Alexander MSM, Dias PS, Uttley D (1986) Spontaneous subarachnoid haemorrhage and negative cerebral panangiography. J Neurosurg 64: 537–542

    PubMed  Google Scholar 

  2. Amthauer R (1953) Der Intelligenz-Struktur-Test IST, 2nd Ed. Verlag für Psychologie, Göttingen

    Google Scholar 

  3. Arnold H, Nowak G, Schwachenwald R (1990) Subarachnoidalblutung: Verbesserte Prognose dank Frühoperation, Kalzium-Antagonisten, Vermehrung des zirkulierenden Blutvolumens und Senkung der Blutviskosität. In: Walter W, Krenkel W (eds) Jahrbuch der Neurochirurgie. Biermann, Zülpich, pp 126–161

    Google Scholar 

  4. Bäumler G (1985) Der Farbe-Wort-Interferenztest (FWIT). Verlag für Psychologie, Göttingen

    Google Scholar 

  5. Beguelin C, Seiler R (1983) Subarachnoid haemorrhage with normal cerebral panangiography. Neurosurgery 13: 409–411

    PubMed  Google Scholar 

  6. Benton AL (1981) Der Benton-Test. Huber, Bern

    Google Scholar 

  7. Benton AL (1985) Reaction time in brain disease: some reflections. Cortex 21: 129–140

    Google Scholar 

  8. Bornstein RA, Weir BKA, Petruk KC, Disney LB (1987) Neuropsychological function in patients after subarachnoid haemorrhage. Neurosurgery 21: 651–654

    PubMed  Google Scholar 

  9. Brickenkamp R (1978) Test d2 Aufmerksamkeits-Belastungs-Test. Verlag für Psychologie, Göttingen

    Google Scholar 

  10. Brismar J, Sundbärg G (1985) Subarachnoid haemorrhage of unknown origin: prognosis and prognostic factors. J Neurosurg 63: 349–354

    PubMed  Google Scholar 

  11. Cioffi F, Pasqualin A, Cavazzani P, Da Pian R (1989) Subarachnoid haemorrhage of unknown origin: clinical and tomographical aspects. Acta Neurochir (Wien) 97: 31–39

    Google Scholar 

  12. Dahl G (1972) WIP-Revidierter Wechsler Intelligenztest. Hain, Meisenheim

    Google Scholar 

  13. Eskesen V, Soerensen EB, Rosenoern J, Schmidt K (1984) The prognosis in subarachnoid haemorrhage of unknown etiology. J Neurosurg 61: 1029–1031

    PubMed  Google Scholar 

  14. Findlay JM, Weir BKA, Kassell NF, et al (1991) Intracisternal recombinant tissue plasminogen activator after aneurysmal subarachnoid hemorrhage. J Neurosurg 75: 181–188

    PubMed  Google Scholar 

  15. Fisher CM, Kistler JP, Davis JM (1980) Relation of cerebral vasospasm to subarachnoid haemorrhage visualized by computerized tomographic scanning. Neurosurgery 10: 1–9

    Google Scholar 

  16. Gilsbach JM, Reulen HJ, Ljunggren B,et al (1990) Early aneurysm surgery and preventive therapy with intravenously administered nimodipine: a multicenter, double-blind, dose-comparison study. Neurosurgery 26: 458–464

    PubMed  Google Scholar 

  17. Heaton RK, Pendleton MG (1981) Use of neuropsychological tests to predict adult patients every day functioning. J Consult Clin Psychology 49: 807–821

    Google Scholar 

  18. Horn W (1983) Das Leistungsprüfsystem LPS. Verlag für Psychologie, Göttingen

    Google Scholar 

  19. Hunt WE, Hess RM (1968) Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg 28: 4–20

    Google Scholar 

  20. Hunt WE, Kassell N, Pertuiset B, Sano K, Teasdale G, de Villier J, Drake CG (1988) Report of the World Federation of Neurological Surgeons Committee on a Universal Subarachnoid Haemorrhage Grading Scale. J Neurosurg 68: 985–986

    PubMed  Google Scholar 

  21. Hütter BO, Gilsbach JM (1992) Gognitive deficits after rupture and early repair of ruptured anterior communicating artery aneurysms. Acta Neurochir (Wien) 116: 6–13

    Google Scholar 

  22. Jennett B, Bond M (1975) Assessment of outcome after severe brain damage. A practical scale. Lancet i: 480–484

    Google Scholar 

  23. Juul R, Fredriksen TA, Ringkjoeb R (1986) Prognosis in subarachnoid hemorrhage of unknown etiology. J Neurosurg 64: 359–362

    PubMed  Google Scholar 

  24. Lezak MD (1983) Neuropsychological assessment, 2nd Ed. Oxford University Press, New York

    Google Scholar 

  25. Ljunggren B, Sonesson B, Säveland H, Brandt L (1985) Cognitive impairment and adjustment in patients without neurological deficits after aneurysmal SAH and early operation. J Neurosurg 62: 673–679

    PubMed  Google Scholar 

  26. Ljunggren B, Brandt L, Säveland H,et al (1987) Managementa of ruptured intracranial aneurysm: a review. Br J Neurosurg 1: 9–32

    PubMed  Google Scholar 

  27. McKenna P, Willison JR, Lowe D, Neil-Dwyer G (1989) Cognitive outcome and quality of life one year after subarachnoid haemorrhage. Neurosurgery 24: 361–367

    PubMed  Google Scholar 

  28. Nishioka H, Torner JC, Graf CJ,et al (1984) Cooperative study of intracranial aneurysms and subarachnoid haemorrhage: a long prognostic study. III: subarachnoid haemorrhage of undetermined aetiology. Arch Neurol 41: 1147–1151

    PubMed  Google Scholar 

  29. Oder W, Kollegger H, Zeiler K,et al (1991) Subarachnoid hemorrhage of unknown etiology: early prognostic factors for long-term functional capacity. J Neurosurg 74: 601–605

    PubMed  Google Scholar 

  30. Orgass B (1982) Deutsche Bearbeitung des Token Tests von E DeRenzi und LA Vignolo. Beltz, Weinheim

    Google Scholar 

  31. Peock K (1990) Klinische Neuropsychologie, 2nd Ed. Thieme, Stuttgart

    Google Scholar 

  32. Rauchfleisch U (1983) Zur Reliabilität und Validität des Aufmerksamkeits-Belastungs Tests (Test d 2) bei Patienten mit hirndiffusem Psychosyndrom und neurotischen Störungen. Diagnostica 24: 247–255

    Google Scholar 

  33. Säveland H, Sonesson B, Ljunggren B,et al (1986) Outcome evaluation following subarachnoid hemorrhage. J Neurosurg 64: 191–196

    PubMed  Google Scholar 

  34. Shepard RH (1984) Prognosis of spontaneous (nontraumatic) subarachnoid haemorrhage of unknown cause. Lancet VII: 777–778

    Google Scholar 

  35. Sonesson B, Säveland H, Ljunggren B, Brandt L (1989) Cognitive functioning after subarachnoid haemorrhage of unknown origin. Acta Neurol Scand 80: 400–410

    PubMed  Google Scholar 

  36. Sonesson B, Ljunggren B, Säveland H, Brandt L (1987) Cognition and adjustment following late and early surgery for ruptured aneurysms. Neurosurgery 21: 279–287

    PubMed  Google Scholar 

  37. Spallone A, Ferrante L, Palatinsky E,et al (1986) Subarachnoid haemorrhage of unknown origin. Acta Neurochir (Wien) 80: 12–17

    Google Scholar 

  38. Stolke D, Seifert V (1992) Single intracisternal bolus injection of recombinant tissue plasminogen activator (rtPA) in patients with aneurysmal subarachnoid hemorrhage: preliminary assessment of efficacy and safety in an open clinical study. Neurosurgery 30: 877–881

    PubMed  Google Scholar 

  39. TÜV-Baden VO/TÜV/MPI (1976) Testnormen für das Wiener Determinationsgerät. TÜV-Baden, Freiburg

    Google Scholar 

  40. Vilkki J, Holst P, Öhman J,et al (1990) Social outcome related to cognitive performance and computed tomographic findings after surgery for a ruptured intracranial aneurysm. Neurosurgery 26: 579–585

    PubMed  Google Scholar 

  41. Von Klebelsberg D (1960) Das Wiener Determinationsgerät. Diagnostica 6: 165–166

    Google Scholar 

  42. Yaşargil MG (1984) Microneurosurgery, Vol 1 and 2. Thieme, Stuttgart

    Google Scholar 

  43. Zabramsky JM, Spetzler RF, Lee KS,et al (1991) Phase I trial of tissue plasminogen activator for the prevention of vasospasm in patients with aneurysmal subarachnoid hemorrhage. J Neurosurg 75: 189–196

    PubMed  Google Scholar 

Download references

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Hütter, B.O., Gilsbach, J.M. & Kreitschmann, I. Is there a difference in cognitive deficits after aneurysmal subarachnoid haemorrhage and subarachnoid haemorrhage of unknown origin?. Acta neurochir 127, 129–135 (1994). https://doi.org/10.1007/BF01808755

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