Cognitive Impairment in Aneurysmal Subarachnoid Hemorrhage Patients with Delayed Cerebral Infarction: Prevalence and Pattern
Background: Cognitive deficits commonly occur after aneurysmal subarachnoid hemorrhage (aSAH) and clinical understanding is important for treatment and rehabilitation. Delayed cerebral infarction was shown to be related to poor outcome. Data on delayed cerebral infarction-related cognitive impairment were lacking.
Objective: We investigated the prevalence and pattern of delayed cerebral infarction-associated cognitive impairment.
Methods: We carried out a prospective observational and diagnostic accuracy study in Hong Kong in patients aged 21–75 years with aSAH who had been admitted within 96 h of ictus. The domain-specific neuropsychological assessment battery at 1 year after ictus was used for cognitive assessments. A cognitive domain deficit was defined as a cognitive domain z score less than −1.65 (below the fifth percentile). Cognitive impairment was defined by two or more cognitive domain deficits. The current study is registered at ClinicalTrials.gov of the U.S. National Institutes of Health (NCT01038193).
Results: One hundred and twenty aSAH patients were recruited. Patients with delayed cerebral infarction (DCI) have cognitive impairment more frequently (22 % vs 11 %; odds ratio: 2.2, 0.6 to 7.8, p = 0.192). Cognitive domain deficits commonly affected in aSAH patients with delayed cerebral infarction were verbal memory, language, and visuospatial memory and skill domains, and were relatively uncommon in aSAH patients without delayed cerebral infarction.
Conclusion: In patients with aSAH, delayed cerebral infarction was associated with a specific pattern of cognitive domain deficits. The pathophysiology should be further investigated.
KeywordsAneurysm Cognitive impairment Stroke Subarachnoid hemorrhage
Conflict of Interest Statement/Financial Disclosure
We declare that we have no conflict of interest.
- 3.Chan AS, Kwok I (1999) Hong Kong list learning test: manual and preliminary norm. Department of Psychological and Clinical Psychology Center, Hong KongGoogle Scholar
- 6.Lam CL, Lauder IJ, Lam TP, Gandek B (1999) Population based norming of the Chinese (HK) version of the SF-36 health survey. H K Pract 21:460–470Google Scholar
- 9.Rey A (1941) L’examen psychologique dans les cas d’encephalopathie traumatique. Arch de Psychologie 28:296–302Google Scholar
- 13.Wechsler D (2005) Wechsler Memory Scale III (Chinese): manual. Psychological Corporation, TaiwanGoogle Scholar
- 16.Wong GK, Lam SW, Ngai K, Wong A, Mok V, Poon WS, Cognitive Dysfunction after Aneurysmal Subarachnoid Haemorrhage Investigators (2012) Evaluation of cognitive impairment by the Montreal cognitive assessment in patients with aneurysmal subarachnoid haemorrhage: prevalence, risk factors and correlations with 3 month outcomes. J Neurol Neurosurg Psychiatry 83:1112–1117PubMedCrossRefGoogle Scholar
- 17.Wong GK, Lam SW, Ngai K, Wong A, Poon WS, Mok V, Cognitive Dysfunction after Aneurysmal Subarachnoid Haemorrhage Investigators (2013) Cognitive domain deficits in patients with aneurysmal subarachnoid haemorrhage at 1 year. J Neurol Neurosurg Psychiatry 84:1054–1058PubMedCrossRefPubMedCentralGoogle Scholar
- 20.Wong GK, Poon WS (2013) Clinical, transcranial Doppler ultrasound, radiological features and prognostic significance. Acta Neurochir Suppl 113:9–11Google Scholar