Long-term Neuropsychiatric and Neuropsychological Sequelae of Endovascularly Treated Aneurysmal Subarachnoid Hemorrhage.

Abstract

INTRODUCTION\nThere is limited evidence regarding long-term outcomes of aneurysmal subarachnoid hemorrhage survivors. Most follow-up programs are relatively short and focused on physical functions. Endovascular aneurysmal embolization enables recovery of\xa0normal vascular architecture. However, there is growing evidence that neuropsychological and behavior sequelae can significantly impact\xa0the lives of these patients, even when treatment is successful. In this study, we reviewed cognition, psychiatric and neuropsychological\xa0symptoms, global functionality, and health-related quality of life 10 to 12 years after an aneurysmal subarachnoid hemorrhage.\n\n\nMATERIAL AND METHODS\nA cross-sectional observational study was carried out in a university hospital. All cases of aneurysmal subarachnoid\xa0hemorrhage admitted between January 2004 and December 2006 and endovascularly treated were reviewed. Participants\xa0underwent a neuropsychological evaluation and a clinical interview with a psychiatrist.\n\n\nRESULTS\nFourteen patients participated in the study. Almost 70% (n = 10) showed cognitive impairment; in more than 40% (n = 6) of\xa0the subjects, significant symptoms of anxiety were identified, and 35% (n = 5) were classified as having clinical depression. Relevant\xa0posttraumatic symptoms were reported by more than 70% (n = 10) of patients, and almost 30% (n = 4) showed other moderate neuropsychiatric\xa0symptoms. Overall, health-related quality of life was impaired, and personality changes were frequently reported by the\xa0participants and their relatives.\n\n\nDISCUSSION\nA significant prevalence of ongoing deficits in high-level functioning and reduced health-related quality of life were observed\xa0in a sample of young and professionally active individuals that were successfully treated and discharged from follow-up consultations.\n\n\nCONCLUSION\nThere is a need for better follow-up strategies, targeting more subtle deficits and psychological symptoms after aneurysmal\xa0subarachnoid hemorrhage.