Current practice in neuropsychological outcome reporting after aneurysmal subarachnoid haemorrhage

Abstract

Background

Neuropsychological deficits (NPD) are common in patients with aneurysmal subarachnoid haemorrhage (aSAH). NPD are one of the major limiting factors for patients with an otherwise acceptable prognosis for sustained quality of life. There are only a few studies reporting outcome after aSAH, which used a standardized neuropsychological test battery as a primary or secondary outcome measure. Aim of this study was to determine the current practice of reporting NPD following aSAH in clinical studies.

Methods

A MEDLINE analysis was performed using the search term “subarachnoid haemorrhage outcome”. The latest 1,000 articles were screened. We recorded study design, number of patients, and the presence of neuropsychological outcome report. Additionally, the time of testing after aSAH, the neuropsychological tests administered, as well as the percentage of patients with NPD were analyzed.

Results

A total of 324 publications between 2009 and 2012 were selected for further review. Of those, 21 studies (6.5%) reported neuropsychological outcome, in 2,001 of 346,666 patients (0.6%). The assessment of NPD differed broadly using both subjective and objective cognitive evaluation, and a large variety of tests were used.

Conclusion

Neuropsychological outcome is underreported, and there is great variety in assessment in currently published clinical articles on aSAH. Prospective randomized trials treating aSAH may benefit from implementing more comprehensive and standardized neuropsychological outcome measures. This approach might identify otherwise unnoticed treatment effects in future interventional studies of aSAH patients.

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Source of funding

There was no funding for this study.

Disclosures

None.

Conflicts of interest

None.

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Correspondence to Martin N. Stienen.

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Comment

This is a well-written, thoughtfully constructed manuscript that will make a meaningful contribution to the literature and encourage cerebrovascular neurosurgeons and neurological critical care physicians who wish to improve outcomes in aneurysmal subarachnoid hemorrhage to incorporate neuropsychological testing into their routine post-operative rehabilitation regimens.

Christopher Loftus

Illinois, USA

Members and their affiliations are listed in the appendix

Appendix

Appendix

Further Swiss SOS contributors are listed below:

Ali-Reza Fathi - Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

Kerstin Winkler, Christoph Woernle, René Bernays - Department of Neurosurgery/Neurointensive Care Unit, University Hospital of Zurich, Zurich, Switzerland

Roy Thomas Daniel, Marc Levivier, Fabian Baumann - Department of Neurosurgery, Lausanne University Hospital, Lausanne, Switzerland

Peter Ahlborn, Martin Seule - Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland

Daniel Zumofen, Luigi Mariani, Michel Roethlisberger, Donato D’Alonzo - Department of Neurosurgery, Basel University Hospital, Basel, Switzerland

Andreas Raabe - Department of Neurosurgery (2a) Department of Intensive Care Medicine, Inselspital, Bern, Switzerland

Christian Chicherio - Department of Neurology, Neuropsychology Unit, University Hospital Geneva, Geneva, Switzerland

Michael Reinert - Department of Neurosurgery, Ospedale Regionale di Lugano, Lugano, Switzerland

Leonardo Sacco - Department of Neurology, Neuropsychology Unit, Ospedale Regionale di Lugano, Lugano, Switzerland

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Stienen, M.N., Weisshaupt, R., Fandino, J. et al. Current practice in neuropsychological outcome reporting after aneurysmal subarachnoid haemorrhage. Acta Neurochir 155, 2045–2051 (2013). https://doi.org/10.1007/s00701-013-1823-9

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Keywords

  • Subarachnoid haemorrhage
  • Cognitive impairment
  • Aneurysm
  • Clinical trial
  • Neuropsychology