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01.09.2015 | Clinical Article - Vascular

Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations

verfasst von: Antoinette E. Zweifel-Zehnder, Martin N. Stienen, Christian Chicherio, Aline Studerus-Germann, Stefan Bläsi, Stefania Rossi, Klemens Gutbrod, Nicole Schmid, Valérie Beaud, Christian Mondadori, Peter Brugger, Leonardo Sacco, Rene Müri, Gerhard Hildebrandt, Jean-Yves Fournier, Emanuela Keller, Luca Regli, Javier Fandino, Luigi Mariani, Andreas Raabe, Roy Thomas Daniel, Michael Reinert, Thomas Robert, Bawarjan Schatlo, Philippe Bijlenga, Karl Schaller, Andreas U. Monsch, on behalf of the Swiss SOS study group

Erschienen in: Acta Neurochirurgica | Ausgabe 9/2015

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Abstract

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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Titel: Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations
verfasst von: Antoinette E. Zweifel-Zehnder
Martin N. Stienen
Christian Chicherio
Aline Studerus-Germann
Stefan Bläsi
Stefania Rossi
Klemens Gutbrod
Nicole Schmid
Valérie Beaud
Christian Mondadori
Peter Brugger
Leonardo Sacco
Rene Müri
Gerhard Hildebrandt
Jean-Yves Fournier
Emanuela Keller
Luca Regli
Javier Fandino
Luigi Mariani
Andreas Raabe
Roy Thomas Daniel
Michael Reinert
Thomas Robert
Bawarjan Schatlo
Philippe Bijlenga
Karl Schaller
Andreas U. Monsch
on behalf of the Swiss SOS study group
Publikationsdatum: 01.09.2015
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 9/2015
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-015-2480-y

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