Author/Editor		Ravnik, Janez; Starovasnik, Barbara; Šešok, Sanja; Pirtošek, Zvezdan; Švigelj, Viktor; Bunc, Gorazd; Bošnjak, Roman
Title		Long-term cognitive deficits in patients with good outsomes after aneurysmal subarachnoid hemorrhage from anterior communicating artery
Type		članek
Source		Croat Med J
Vol. and No.		Letnik 47, št. 2
Publication year		2006
Volume		str. 253-63
Language		eng
Abstract		Aim To evaluate long-term cognitive consequences of subarachnoid hemorrhage with good outcome and the opinion of patients and their relatives about these consequences. Methods The study included 10 patients surgically treated for subarachnoid hemorrhage due to the rupture of aneurysm of the anterior communicating artery 2 or more years earlier, and 10 age- and sex-matched healthy controls. The preoperative and postoperative course in the patients was uneventful. Clinical and psychosocial factors and cognitive status of the patients were assessed by use of checklists and neuropsychological tests for executive functions, attention, and memory, and event-related potential recordings (waves P3a and P3b) with tree-stimulus auditory oddball paradigm, which was also performed in healthy controls. Results The number of reported cognitive problems negatively correlated with the patients' level of community integration (p range, -0.22 to -0.75). The average neuropsychological results ranged between the 12th and 46th percentile. Impaired results were found in 7 patients across different tests and were most frequent for visual memory, followed by verbal memory and executive functions. A clear decline in cognitive functioning was observed in 3 patients. Neither P3a nor P36 wave could be found in 3 patients. In comparison with controls, patients had significantly longer P36 wave latencies (364 vs 334 ms; Mann-Whitney U test, P= 0.025). We found statisticallv non-significant, but still prominent negative correlations between the sustained attention results and latencies of P3a (ro = -0.58; P = 0.172) and P3b (ro = -0.58; P = 0.172) waves. Conclusion Despite good outcome after subarachnoid hemorrhage, persistent cognitive consequences were still manifest, limiting the patients' psychosocial functioning. The correlation between neuropsychological and neurophysiological measures indicated frontal lobe damage, which in some patients persisted for years after the hemorrhage.
Descriptors		SUBARACHNOID HEMORRHAGE CEREBRAL ANEURYSM COGNITION DISORDERS ATTENTION MEMORY DISORDERS EVENT-RELATED POTENTIALS, P300 TOMOGRAPHY, X-RAY COMPUTED