Cognitive consequences of aneurysmal and angiogram-negative subarachnoid hemorrhage:A comparison to matched healthy controls

Objectives: Generally, aneurysmal subarachnoid hemorrhage (aSAH) is considered to have more severe consequences than angiogram-negative SAH (anSAH). However, research on neuropsychological outcome post-SAH is still quite limited and inconclusive. Therefore, this study aims to investigate cognitive consequences of aSAH and anSAH, compared with healthy controls. Methods: In the subacute phase (M=5 months post-SAH), patients conducted a neuropsychological test battery measuring memory (Dutch Version of the Verbal Learning Test, Groningen Fifteen Words Test; 15WT), attention (Trail Making Test; TMT), executive functioning (Zoo Map), fluency (Dutch Version of the Controlled Word Association Test; Letter Fluency), and social cognition (Facial Expressions of Emotion: Stimuli and Tests; FEEST). Results were compared between aSAH patients, anSAH patients and healthy controls matched for age, sex, and educational level, by using Mann-Whitney and independent t-tests. Results: 30 anSAH patients (46.7% male, 53.3% female, mean age 53.8 years) and 90 aSAH patients (31.1% male, 68.9% female, mean age 53.1 years) were investigated. aSAH patients performed significantly worse on all neuropsychological tests (all ps<0.05) compared to healthy controls. anSAH patients had lower scores than healthy controls on all tests, except the TMT. This difference was only significant for the Zoo Map (p=0.045). Conclusions: In the subacute phase post-injury aSAH patients showed cognitive impairments in every investigated domain. Scores of anSAH patients were lower than those of healthy controls, but did not reach significance, except for executive functioning. Clearly, cognitive rehabilitation is warranted for aSAH patients, but also anSAH patients might benefit from treatment although their problems are subclinical