Publication
Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations
Journal Paper/Review - Jul 16, 2015
Zweifel-Zehnder Antoinette E, Keller Emanuela, Regli Luca, Fandino Javier, Mariani Luigi, Raabe Andreas, Daniel Roy Thomas, Reinert Michael, Robert Thomas, Schatlo Bawarjan, Bijlenga Philippe, Schaller Karl, Monsch Andreas U, Fournier Jean-Yves, Hildebrandt Gerhard, Stienen Martin N., Chicherio Christian, Studerus-Germann Aline, Bläsi Stefan, Rossi Stefania, Gutbrod Klemens, Schmid Nicole, Beaud Valérie, Mondadori Christian, Brugger Peter, Sacco Leonardo, Müri Rene, Swiss SOS study group
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PubMed
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Citation
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Journal
Publication Date
Issn Electronic
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Brief description/objective
BACKGROUND
In a high proportion of patients with favorable outcome after aneurysmal subarachnoid hemorrhage (aSAH), neuropsychological deficits, depression, anxiety, and fatigue are responsible for the inability to return to their regular premorbid life and pursue their professional careers. These problems often remain unrecognized, as no recommendations concerning a standardized comprehensive assessment have yet found entry into clinical routines.
METHODS
To establish a nationwide standard concerning a comprehensive assessment after aSAH, representatives of all neuropsychological and neurosurgical departments of those eight Swiss centers treating acute aSAH have agreed on a common protocol. In addition, a battery of questionnaires and neuropsychological tests was selected, optimally suited to the deficits found most prevalent in aSAH patients that was available in different languages and standardized.
RESULTS
We propose a baseline inpatient neuropsychological screening using the Montreal Cognitive Assessment (MoCA) between days 14 and 28 after aSAH. In an outpatient setting at 3 and 12 months after bleeding, we recommend a neuropsychological examination, testing all relevant domains including attention, speed of information processing, executive functions, verbal and visual learning/memory, language, visuo-perceptual abilities, and premorbid intelligence. In addition, a detailed assessment capturing anxiety, depression, fatigue, symptoms of frontal lobe affection, and quality of life should be performed.
CONCLUSIONS
This standardized neuropsychological assessment will lead to a more comprehensive assessment of the patient, facilitate the detection and subsequent treatment of previously unrecognized but relevant impairments, and help to determine the incidence, characteristics, modifiable risk factors, and the clinical course of these impairments after aSAH.