scholarly journals Fatigue After Aneurysmal Subarachnoid Hemorrhage: Clinical Characteristics and Associated Factors in Patients With Good Outcome

2021 ◽  
Vol 15 ◽  
Author(s):  
Elin Western ◽  
Tonje Haug Nordenmark ◽  
Wilhelm Sorteberg ◽  
Tanja Karic ◽  
Angelika Sorteberg
Keyword(s):  
Weight Gain ◽  
Subarachnoid Hemorrhage ◽  
Cognitive Functioning ◽  
Mood Disorders ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Strong Association ◽  
Occupational Status ◽  
Mental Fatigue ◽  
Prior History ◽  
Good Outcome

Fatigue after aneurysmal subarachnoid hemorrhage (post-aSAH fatigue) is a frequent, often long-lasting, but still poorly studied sequel. The aim of the present study was to characterize the nature of post-aSAH fatigue with an itemized analysis of the Fatigue Severity Scale (FSS) and Mental Fatigue Scale (MFS). We further wanted to assess the association of fatigue with other commonly observed problems after aSAH: mood disorders, cognitive problems, health-related quality of life (HRQoL), weight gain, and return to work (RTW). Ninety-six good outcome aSAH patients with fatigue completed questionnaires measuring fatigue, depression, anxiety, and HRQoL. All patients underwent a physical and neurological examination. Cognitive functioning was assessed with a neuropsychological test battery. We also registered prior history of fatigue and mood disorders as well as occupational status and RTW. The patients experienced fatigue as being among their three most disabling symptoms and when characterizing their fatigue they emphasized the questionnaire items “low motivation,” “mental fatigue,” and “sensitivity to stress.” Fatigue due to exercise was their least bothersome aspect of fatigue and weight gain was associated with depressive symptoms rather than the severity of fatigue. Although there was a strong association between fatigue and mood disorders, especially for depression, the overlap was incomplete. Post-aSAH fatigue related to reduced HRQoL. RTW was remarkably low with only 10.3% of patients returning to their previous workload. Fatigue was not related to cognitive functioning or neurological status. Although there was a strong association between fatigue and depression, the incomplete overlap supports the notion of these two being distinct constructs. Moreover, post-aSAH fatigue can exist without significant neurological or cognitive impairments, but is related to reduced HRQoL and contributes to the low rate of RTW.

Quality of Life 1 Year after Aneurysmal Subarachnoid Hemorrhage in Good Outcome Patients Treated by Clipping or Coiling

2012 ◽  
Vol 73 (04) ◽  
pp. 217-223 ◽  
Author(s):  
Marek Preiss ◽  
David Netuka ◽  
Jana Koblihova ◽  
Lenka Bernardova ◽  
Frantisek Charvat ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Good Outcome

Intra-arterial vasodilators for vasospasm following aneurysmal subarachnoid hemorrhage: a meta-analysis

2017 ◽  
Vol 10 (4) ◽  
pp. 380-387 ◽  
Author(s):  
Anand Venkatraman ◽  
Ayaz M Khawaja ◽  
Sahil Gupta ◽  
Shalaka Hardas ◽  
John P Deveikis ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Outcome ◽  
Patient Selection ◽  
Balloon Angioplasty ◽  
Medical Management ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Meta Analysis ◽  
Neurological Improvement ◽  
Good Outcome ◽  
Neurological Response

ObjectiveThe efficacy of intra-arterial vasodilators (IADs) for the treatment of vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) remains debatable. The objective of this meta-analysis was to pool estimates of angiographic and neurological response, clinical outcome, and mortality following treatment of vasospasm with IADs.MethodsWe searched PubMed, Embase, Scopus, Clinicaltrials.gov, Cochrane database, and CINAHL in December 2015 and August 2016. Studies reporting angiographic and neurological response, clinical outcome, and mortality following IAD treatment of vasospasm in 10 or more adults with aSAH were included. All established IADs were allowed. Two authors independently selected studies and abstracted the data. Mean weighted probabilities (MWP) were calculated using random effects model.ResultsInclusion criteria were met by 55 studies (n=1571). MWP for immediate angiographic response to IAD treatment was 89% (95% CI 83% to 94%), post-IAD neurological improvement 57% (95% CI 49% to 65%), good outcome 66% (95% CI 60% to 71%), and mortality was 9% (95% CI 7% to 12%). After adjusting for publication bias, MWP for mortality was 5% (95% CI 4% to 7%). When transcranial Doppler (TCD) was used along with clinical deterioration for patient selection, rates of neurological response (64%) and good outcome (72%) were better. IADs were not superior to controls (balloon angioplasty or medical management).ConclusionIAD treatment leads to a robust angiographic response and fair (but lower) rates of neurological response and good clinical outcome. Mortality was lower than the average reported in the literature. Rates of neurological response and good outcome were better when TCD was used for patient selection. Carefully designed studies are needed to compare IADs against medical management and balloon angioplasty.

Warning leak and management outcome in aneurysmal subarachnoid hemorrhage

1996 ◽  
Vol 85 (6) ◽  
pp. 995-999 ◽  
Author(s):  
Karl-Erik Jakobsson ◽  
Hans Säveland ◽  
Jan Hillman ◽  
Göran Edner ◽  
Stefan Zygmunt ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Correct Diagnosis ◽  
Medical Attention ◽  
Consecutive Series ◽  
Content Type ◽  
Good Outcome ◽  
The Difference ◽  
The Impact ◽  
Fine Print

✓ The impact of warning leaks on management results in patients with aneurysmal subarachnoid hemorrhage (SAH) was evaluated in this prospective study. In a consecutive series of 422 patients with aneurysmal SAH, 84 patients (19.9%) had an episode suggesting a warning leak; 34 (40.5%) of these patients were seen by a physician without the condition being recognized. The warning leak occurred less than 2 weeks before a major SAH in 75% of the patients. A good outcome was experienced by 53.6% of patients who had a warning leak versus 63.3% of those who had no warning leak. In a subgroup of patients who had an interval of 3 days or less from warning leak to SAH, only 36.4% had a good outcome. The proportion of patients in good neurological condition (Hunt and Hess Grades I and II) who had a good outcome was 88.1% in the group with no warning leak versus 53.6% in the group whose SAH was preceded by a warning leak. A difference of 35% between these two groups reflects the impact of an undiagnosed warning leak on patient outcome, based on the assumption that patients with a warning leak had clinical conditions no worse than Hunt and Hess Grade II at the time of the episode. In the subgroup of patients with the short interval between warning leak and SAH, the difference was almost 52%. The difference in outcome also reflects the potential improvement in outcome that can be achieved by a correct diagnosis of the warning leak. If the correct diagnosis is made in patients seeking medical attention due to a warning leak, favorable outcomes in the overall management of aneurysmal SAH are estimated to increase by 2.8%. An active diagnostic attitude toward patients experiencing a sudden and severe headache is warranted as it offers a means of improving overall outcome in patients with SAH.

scholarly journals Does establishing a neurovascular unit improve the outcome after surgical clipping for aneurysmal subarachnoid hemorrhage? Results from a 5-year observational study in Kuwait

2021 ◽  
Vol 12 ◽  
pp. 547
Author(s):  
Ahmad Kh Alhaj ◽  
Waleed Yousef ◽  
Abdulrahman Alanezi ◽  
Mariam Almutawa ◽  
Salem Zaidan ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Cohort Analysis ◽  
Neurovascular Unit ◽  
High Morbidity ◽  
Surgical Clipping ◽  
Good Outcome ◽  
Poor Outcome ◽  
The Poor ◽  
Postoperative Intensive Care

Background: Failure to prevent rebleeding after cerebral subarachnoid hemorrhage (SAH) is the most frequent reason for high morbidity and mortality of aneurysmal SAH. Our study aims to identify the outcome after surgical clipping of aneurysmal SAH before and after the establishment of the neurovascular unit. The clarifications of the positive turnover in the outcome will be discussed. Methods: A retrospective cohort analysis was carried out on our experience with a controlled group of patients who underwent clipping for ruptured cerebral aneurysms (n = 61) from January 2015 to December 2019. A modified Rankin scale (mRS) was used to determine the outcome after 6 months of follow-up. Results: The median mRS score (i.e., outcome) on admission was 4, whereas it was with a median score of 2 six months after clipping (P ≤ 0.001). Overall, the cases with a good outcome were 63.9% of the sample, while the poor outcome conditions were 36.1%. The most cases with an improved outcome were after introducing the neurovascular unit, representing a transition of aneurysmal clipping practice in our center. The good outcome was changed from 42% to 76.7%, and the poor outcome was changed from 58% to 23.3% (P = 0.019). The crude mortality rate was similar to the rate worldwide (18%), with a noticeable decrease after organizing a neurovascular subspecialty. Conclusion: The outcome after clipping of ruptured SAH can be largely affected by the surgeon’s experience and postoperative intensive care. Organizing a neurovascular team is one of the major factors to achieve good outcomes.

scholarly journals Mental fatigue assessment may add information after aneurysmal subarachnoid hemorrhage

2019 ◽  
Vol 9 (7) ◽  
Author(s):  
Ann Sörbo ◽  
Ingrid Eiving ◽  
Pia Löwhagen Hendén ◽  
Silvana Naredi ◽  
Johan Ljungqvist ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Mental Fatigue ◽  
Fatigue Assessment

Cardiac Arrest in Patients with Poor-Grade Aneurysmal Subarachnoid Hemorrhage: A Single-Center Experience

2019 ◽  
Vol 80 (06) ◽  
pp. 409-412
Author(s):  
Sami Ridwan ◽  
Rudolf Kristof
Keyword(s):  
Cardiac Arrest ◽  
Subarachnoid Hemorrhage ◽  
Clinical Outcome ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Statistical Significance ◽  
Case Fatality ◽  
Poor Grade ◽  
Good Outcome ◽  
Grade 5 ◽  
Clinical Records

Abstract Background Poor-grade aneurysmal subarachnoid hemorrhage (SAH), in particular Hunt and Hess (H&H) grade 5 SAH, still has a high case-fatality rate. Recent studies regarding the clinical outcome of such patients and the influence of comorbidities, especially cardiac arrest (CA) requiring additional cardiopulmonary resuscitation (CPR), on the outcome of these patients are scant. Our primary objective was to assess the outcome of SAH H&H grade 5 patients and the influence of additional CA and requirement for CPR. Methods All patients with spontaneous aneurysmal SAH H&H grade 5 admitted to our hospital from 2001 to 2010 were enrolled in the study. Data were extracted from the hospital's clinical records and electronic database. The patients' clinical outcome at time of discharge was represented by the Glasgow Outcome Score and modified Rankin Scale (mRS). The influence of CA and additional CPR on patient outcome was analyzed. Results Of 80 SAH H&H grade 5 patients (median age 55 years), 21 patients (median age 50 years) experienced CA and received additional CPR. Mortality in SAH H&H grade 5 patients was 85% with CA and 68% without CA (p = 0.158). Overall, 22 of 59 patients with no CA survived, 4 with a good clinical outcome (mRS 0–3). Of the 21 with CA, only 3 survived, none with a good outcome (mRS 4–5). Due to the small subgroup surviving additional CA, a statistical difference could not be found between the groups. Aneurysm occlusion (p < 0.001) and aneurysm of the posterior circulation (p = 0.010) resulted in a more favorable clinical outcome. Conclusions Patients with SAH H&H grade 5 do survive and in 5% of cases even with a good outcome. Surviving an additional CA resulted in a less favorable outcome without statistical significance. Thus SAH H&H grade 5 patients with or without CA and additional CPR should not be excluded from appropriate neurosurgical treatment.

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