Abstract
Methods Prospective study included 40 cases with acute aSAH. Initial evaluation by Glasgow Coma Scale (GCS) and the severity of aSAH was detected by both the clinical Hunt and Hess and radiological Fisher's grading scales. TCD was done for all patients five times within 10 days measuring the mean flow velocities (MFVs) of cerebral arteries. At the 3-month follow-up, patients were classified into two groups according to Montreal Cognitive Assessment (MoCA) scale: the first group was 31 cases (77.5%) with intact cognitive functions and the other group was 9 cases (22.5%) with impaired cognition. Results Patients with impaired cognitive functions showed significantly lower mean GCS (p = 0.03), significantly higher mean Hunt and Hess scale grades (p = 0.04), significantly higher mean diabetes mellitus (DM) (p = 0.03), significantly higher mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) (p = 0.02 and p = 0.005, respectively), and significantly higher MFVs measured within the first 10 days. The patients with cognitive impairment were accompanied by a higher incidence of hydrocephalus (p = 0.01) and a higher incidence of delayed cerebral ischemia (DCI) (p < 0.001). Logistic regression analysis detected that MFV ≥ 86 cm/s in the middle cerebral artery (MCA), MFV ≥ 68 cm/s in the anterior cerebral artery (ACA), and MFV ≥ 45 cm/s in the posterior cerebral artery (PCA) were significantly associated with increased risk of cognitive impairment. Conclusion Cognitive impairment after the 3-month follow-up phase in aSAH patients was 22.5%. Acute hydrocephalus and DCI are highly associated with poor cognitive function in aSAH. Increased MFV is a strong predictor for poor cognitive function in aSAH. This trial is registered with NCT04329208.
Highlights
Aneurysmal subarachnoid hemorrhage is a form of cerebral hemorrhage that leads to severe injury to the brain with a significant increase in morbidity and mortality [1,2,3]
There was a significant impairment in the subtests of Montreal Cognitive Assessment (MoCA) especially the domains of memory, executive functions, naming, and attention, while the domains of the visual-spatial ability, language, and orientation were nonsignificantly diminished after SAH with impaired cognition
Hydrocephalus, Cerebral vasospasm (CV), delayed cerebral ischemia (DCI), and increased mean flow velocities (MFVs) were highly associated with poor cognitive functions
Summary
Aneurysmal subarachnoid hemorrhage is a form of cerebral hemorrhage that leads to severe injury to the brain with a significant increase in morbidity and mortality [1,2,3]. It is a potentially life-threatening disease that is fatal in about 10-25% of all patients with acute SAH [4]. Hütter and colleagues in 1998 determined impaired short and long-term memory, attention, and frontocortical functions in the acute stage following aSAH (average 6 days) [8].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
