A PROSPECTIVE-STUDY OF IMPAIRMENT OF COGNITION AND MEMORY AND RECOVERY AFTER SUBARACHNOID HEMORRHAGE

IN THIS PROSPECTIVE study, a series of 89 patients with subarachnoid h emorrhage (SAH), most of whom had a ''good'' neurological outcome, wer e assessed with a range of tests of memory and cognition as inpatients and at 10 weeks and 12 months after SAH. On tests of verbal cognition and memory, most patients had scores in the normal range 12 months af ter SAH. However, a significant number of patients still showed impair ment on tests of visuospatial construction and memory, mental flexibil ity, and psychomotor speed at the 12-month assessment. Statistical ana lyses were carried out for each test score to see whether aneurysm sit e, location of blood on the admission computed tomographic scan, vasos pasm, ischemia, hydrocephalus, grades at admission to and at discharge from hospital, and Glasgow Outcome Scale score at follow-up were asso ciated with test scores. Aneurysm site was not shown to be associated with performance on any test at any time, and the other complications of SAH had only minimal predictive value. The grade at discharge prove d to be the best predictor of impairment of cognition and memory at bo th follow-up assessments. Older subjects did not recover to the same e xtent as younger subjects by the 12-month assessment. The authors conc lude that the diffuse effects of SAH are more important than focal neu ropathology in relation to cognitive impairment in this group of patie nts.