Predictors for cognitive impairment one year after surgery for aneurysmal subarachnoid hemorrhage

2008 ◽  
Vol 255 (11) ◽  
pp. 1770-1776 ◽  
Author(s):  
M. Ørbo ◽  
K. Waterloo ◽  
A. Egge ◽  
J. Isaksen ◽  
T. Ingebrigtsen ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
One Year

scholarly journals Microstructural White Matter Abnormalities and Cognitive Impairment After Aneurysmal Subarachnoid Hemorrhage

Stroke ◽  
2018 ◽  
Vol 49 (9) ◽  
pp. 2040-2045 ◽  
Author(s):  
Yael D. Reijmer ◽  
Marc S. van den Heerik ◽  
Rutger Heinen ◽  
Alexander Leemans ◽  
Jeroen Hendrikse ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Subarachnoid Hemorrhage ◽  
White Matter ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
White Matter Abnormalities

Abstract 194: Cognitive Outcome in Acute Simvastatin Treatment for Aneurysmal Subarachnoid Hemorrhage

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
George Wong ◽  
Keyword(s):  
Cognitive Impairment ◽  
Subarachnoid Hemorrhage ◽  
Cerebral Infarction ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Primary Outcome Measure ◽  
Cognitive Outcomes ◽  
Cognitive Outcome ◽  
Secondary Outcome ◽  
Modified Rankin Scale ◽  
Simvastatin Treatment

Objectives: Experimental evidence has indicated the benefit of simvastatin in the treatment of subarachnoid haemorrhage (SAH). Recently, acute simvastatin treatment was not shown to be beneficial in neurological outcome using modified Rankin Scale. Cognitive function is another important dimension of outcome assessment and yet had not been investigated in statin studies for aneurysmal subarachnoid hemorrhage. We therefore explored whether acute simvastatin treatment would improve cognitive outcomes. Methods: The study recruited SAH patients with acute simvastatin treatment enrolled in a randomized controlled double-blinded clinical trial (ClinicalTrials.gov Identifier: NCT01038193). A control cohort of SAH patients without simvastatin treatment was identified with propensity score matching of age and admission grade. Primary outcome measure was Montreal Cognitive Assessment (MoCA). Secondary outcome measures were delayed ischaemic deficit (DID), delayed cerebral infarction, modified Rankin Scale (mRS), and Mini-Mental State Examination( MMSE). Results: Fifty-one SAH patients with acute simvastatin treatment and 51 SAH patients without simvastatin treatment were recruited for analysis. At 3 months, there were no differences in MoCA scores (MoCA: 21+/-6 vs. 21+/-5, p=0.772). MoCA-assessed cognitive impairment (MoCA<26) was not different (75% vs. 80%, OR 0.7, 95%CI 0.3 to 1.8, p=0.477). There were also no differences in DID, delayed cerebral infarction, favorable mRS outcome, and MMSE scores, and MMSE-assessed cognitive impairment between both groups. Conclusions: The current study does not support that acute simvastatin treatment improves cognitive outcome after aneurysmal subarachnoid hemorrhage.

scholarly journals Transcranial Doppler for Early Prediction of Cognitive Impairment after Aneurysmal Subarachnoid Hemorrhage and the Associated Clinical Biomarkers

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Ahmed Esmael ◽  
Tamer Belal ◽  
Khaled Eltoukhy
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Subarachnoid Hemorrhage ◽  
Cognitive Function ◽  
Cerebral Artery ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Clinical Biomarkers ◽  
Poor Cognitive Function ◽  
Impaired Cognition

Background and Aim. Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) stays under investigation. This study is aimed at predicting the cognitive impairment by transcranial Doppler (TCD) and detecting the associated clinical biomarkers of impaired cognition after aSAH after 3 months from the onset. Methods. Prospective study included 40 cases with acute aSAH. Initial evaluation by Glasgow Coma Scale (GCS) and the severity of aSAH was detected by both the clinical Hunt and Hess and radiological Fisher’s grading scales. TCD was done for all patients five times within 10 days measuring the mean flow velocities (MFVs) of cerebral arteries. At the 3-month follow-up, patients were classified into two groups according to Montreal Cognitive Assessment (MoCA) scale: the first group was 31 cases (77.5%) with intact cognitive functions and the other group was 9 cases (22.5%) with impaired cognition. Results. Patients with impaired cognitive functions showed significantly lower mean GCS ( p = 0.03 ), significantly higher mean Hunt and Hess scale grades ( p = 0.04 ), significantly higher mean diabetes mellitus (DM) ( p = 0.03 ), significantly higher mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) ( p = 0.02 and p = 0.005 , respectively), and significantly higher MFVs measured within the first 10 days. The patients with cognitive impairment were accompanied by a higher incidence of hydrocephalus ( p = 0.01 ) and a higher incidence of delayed cerebral ischemia (DCI) ( p < 0.001 ). Logistic regression analysis detected that MFV ≥ 86     cm / s in the middle cerebral artery (MCA), MFV ≥ 68     cm / s in the anterior cerebral artery (ACA), and MFV ≥ 45     cm / s in the posterior cerebral artery (PCA) were significantly associated with increased risk of cognitive impairment. Conclusion. Cognitive impairment after the 3-month follow-up phase in aSAH patients was 22.5%. Acute hydrocephalus and DCI are highly associated with poor cognitive function in aSAH. Increased MFV is a strong predictor for poor cognitive function in aSAH. This trial is registered with NCT04329208.

scholarly journals Effect of hemorrhagic cerebrospinal fluid drainage on cognitive function after intracranial aneurysm clipping

2019 ◽  
Vol 5 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Chaoqun Lin ◽  
Lukui Chen
Keyword(s):  
Cerebrospinal Fluid ◽  
Cognitive Impairment ◽  
Subarachnoid Hemorrhage ◽  
Cognitive Function ◽  
Lumbar Puncture ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Cerebrospinal Fluid Drainage ◽  
Aneurysm Clipping ◽  
Significant Difference ◽  
Drainage Group

Objective: The effects of repeated lumbar puncture and continuous lumbar cistern drainage on the cognitive function of patients with aneurysmal subarachnoid hemorrhage were compared and analyzed. Methods: Retrospective analysis was performed on 59 patients with aneurysmal subarachnoid hemorrhage treated at our Neurosurgery Department between October 2017 and October 2018. According to the hemorrhagic cerebrospinal fluid drainage mode after aneurysm clipping, the patients were divided into the following two groups: the repeated lumbar puncture drainage (Group A, n = 28) and continuous lumbar cistern drainage (Group B, n = 31). Before and 1 month after surgery, the cognitive function of the patients was scored using the Montreal Cognitive Assessment Scale. Scores of 27~30 were defined as normal, and scores of < 27 as cognitive impairment. Results: The incidences of cognitive impairment were 46% (13/28) and 32% (10/31) for Groups A and B, respectively, before surgery, but the difference was not significant ( P > 0.05). The incidences of cognitive impairment were 35% (10/28) and 12% (4/31) for Groups A and B, respectively, at 1 month after surgery, with significant difference ( P < 0.05). Conclusion: Compared with repeated lumbar puncture, continuous lumbar cistern drainage for aneurysmal subarachnoid hemorrhage significantly reduced the incidence of cognitive impairment after aneurysm clipping.

Abstract P39: Outcomes Across the Course of Recovery From Subarachnoid Hemorrhage

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Sean Neifert ◽  
Alexander Schupper ◽  
William Shuman ◽  
Michael Martini ◽  
Emily Chapman ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Secondary Analysis ◽  
Small Samples ◽  
Individual Data ◽  
Chi Square ◽  
Entire Cohort ◽  
One Year ◽  
Time Frames ◽  
Time Point

Introduction: Data on progression of recovery after aneurysmal subarachnoid hemorrhage (aSAH) is rare and limited to small samples. We sought to characterize recovery after SAH in a secondary analysis of six SAH trials. Methods: Individual data on 3,717 patients from CONSCIOUS-1, ISAT, IHAST, trials of erythropoietin and statins, NEWTON-1, and NEWTON-2 was included. Outcome was described with the Glasgow Outcomes Scale (GOS). Proportions of GOS scores between the first and second time-point were compared using chi-square tests. Rates of improvement (final GOS > initial GOS), no change (final GOS = initial GOS), and worsening (final GOS < initial GOS) and the differences between initial and final GOS scores were calculated. Results: There were improvements in outcomes across the entire cohort (p<0.001) and from 30 days to three months (p<0.001), discharge to three months (p<0.001), six weeks to three months (p<0.001), and two months to one year (p<0.001). 907 (26%) of patients improved their outcome, while 2,228 (64%) had no change and 336 (9.7%) worsened. Of the 907 who improved, 773 (85%) improved by one GOS point, 128 (14%) improved by two points, and six (0.7%) improved by three points. Of patients with initial GOS scores of 2, 62 (38%) remained unchanged, while 91 (55%) improved and 11 (6.7%) died. Patient cohorts with initial WFNS grades of 1 (p<0.001), 2 (p<0.001), 3 (p=0.004), and 4 (p<0.001) improved their GOS scores. Conclusions: Across most time-frames, many SAH patients can be expected to recover, while a few will regress. Furthermore, even patients with the poorest initial neurological grades and outcomes showed improvement.

scholarly journals Neurocritical care complications and interventions influence the outcome in aneurysmal subarachnoid hemorrhage

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alexander Hammer ◽  
Frank Erbguth ◽  
Matthias Hohenhaus ◽  
Christian M. Hammer ◽  
Hannes Lücking ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Decompressive Craniectomy ◽  
Odds Ratio ◽  
Neurocritical Care ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Binary Logistic Regression ◽  
World Federation ◽  
Binary Logistic Regression Model ◽  
One Year ◽  
The Impact

Abstract Background This observational study was performed to show the impact of complications and interventions during neurocritical care on the outcome after aneurysmal subarachnoid hemorrhage (SAH). Methods We analyzed 203 cases treated for ruptured intracranial aneurysms, which were classified regarding clinical outcome after one year according to the modified Rankin Scale (mRS). We reviewed the data with reference to the occurrence of typical complications and interventions in neurocritical care units. Results Decompressive craniectomy (odds ratio 21.77 / 6.17 ; p < 0.0001 / p = 0.013), sepsis (odds ratio 14.67 / 6.08 ; p = 0.037 / 0.033) and hydrocephalus (odds ratio 3.71 / 6.46 ; p = 0.010 / 0.00095) were significant predictors for poor outcome and death after one year beside “World Federation of Neurosurgical Societies” (WFNS) grade (odds ratio 3.86 / 4.67 ; p < 0.0001 / p < 0.0001) and age (odds ratio 1.06 / 1.10 ; p = 0.0030 / p < 0.0001) in our multivariate analysis (binary logistic regression model). Conclusions In summary, decompressive craniectomy, sepsis and hydrocephalus significantly influence the outcome and occurrence of death after aneurysmal SAH.

Long-term Excess Mortality of 244 Familial and 1502 Sporadic One-Year Survivors of Aneurysmal Subarachnoid Hemorrhage Compared With a Matched Eastern Finnish Catchment Population

Neurosurgery ◽  
2011 ◽  
Vol 68 (1) ◽  
pp. 20-27 ◽  
Author(s):  
Terhi. Huttunen ◽  
Mikael. von und zu Fraunberg ◽  
Timo. Koivisto ◽  
Antti. Ronkainen ◽  
Jaakko. Rinne ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Glasgow Outcome Scale ◽  
Excess Mortality ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Relative Survival ◽  
Survival Ratio ◽  
Catchment Population ◽  
One Year ◽  
The Impact

Abstract BACKGROUND: Saccular intracranial aneurysms (sIAs) develop in 2% of the population. Rupture of the sIA wall causes almost all cases of aneurysmal subarachnoid hemorrhage (aSAH). OBJECTIVE: We analyzed the long-term excess mortality of 244 familial and 1502 sporadic 1-year survivors of aSAH from sIA compared with a matched Eastern Finnish catchment population. METHODS: The Kuopio Neurosurgery Database contains 1746 one-year survivors of aSAH (1980–2007) from a defined population. The median follow-up time, until death (n = 494) or the end of 2008, was 12 years. Relative survival ratios were calculated compared with the matched (sex, age, calendar time) catchment population. Relative excess risk of death (RER) was estimated for variables known on admission for aSAH as well as Glasgow Outcome Scale score at 12 months. RESULTS: There was 12% excess mortality at 15 years (cumulative relative survival ratio: 0.88; 95% confidence interval: 0.85-0.91). Independent risk factors were male sex (RER: 1.6), age older than 64 years (RER: 2.9), ruptured basilar tip sIA (RER: 4.5), severe hydrocephalus on admission (RER: 3.6), no occlusive therapy (RER: 6.0), and Glasgow Outcome Scale scores of 2, 3, or 4 at 12 months (RER: 23, 4.1, 2.1, respectively), but not familial sIA disease. There were lethal rebleeds from 13 of the 1440 clipped sIAs, 2 of the 265 coiled sIAs, and 2 from the 17 nonoccluded sIAs, and 14 new lethal bleeds from other sIAs. CONCLUSION: The impact of both sporadic and familial aSAH and their sequelae in the central nervous and cardiovascular systems may cause long-term morbidity and mortality. The complex sIA disease may predispose to other vascular events later in life. The causes of the long-term excess mortality are heterogeneous, and more detailed analyses are required.

Sign in / Sign up

Export Citation Format

Share Document