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Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations.
Acta Neurochir (Wien) ; 157(9): 1449-58, 2015 Sep.
Article en En | MEDLINE | ID: mdl-26179382
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hemorragia Subaracnoidea / Aneurisma Intracraneal / Pruebas Neuropsicológicas Tipo de estudio: Etiology_studies / Guideline / Risk_factors_studies Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Acta Neurochir (Wien) Año: 2015 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Austria

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hemorragia Subaracnoidea / Aneurisma Intracraneal / Pruebas Neuropsicológicas Tipo de estudio: Etiology_studies / Guideline / Risk_factors_studies Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Acta Neurochir (Wien) Año: 2015 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Austria