WHICH NEUROPSYCHOLOGICAL DEFICITS ARE HIDDEN BEHIND A GOOD OUTCOME (GLASGOW = I) AFTER ANEURYSMAL SUBARACHNOID HEMORRHAGE

A SERIES OF 31 patients with good neurological 6-month outcomes (Glasg ow Outcome Scale = 1) was examined with a battery of cognitive tests 1 to 5 years after aneurysmal subarachnoid hemorrhage (SAH) and early o peration. The results showed a marked disability in 28 to 62% of these patients in the subtests of a complex choice reaction task. Short-ter m memory was impaired in 53% of the patients neuropsychologically exam ined, whereas 21% of them had a reduced long-term memory. Concentratio n was impaired in 7 to 16% of the SAH patients. Also, 10% of the patie nts rated Glasgow Outcome Scale = I had an indication for an aphasic l anguage disturbance. Multivariate analysis proved significant harmful effects of the severity of the bleeding seen on computed tomographic s can (Fisher scale) on information processing and word-finding capacity . Patients who were older at the time of the SAH were significantly mo re disturbed in concentration, short-term memory, and information-proc essing capacity at follow-up. It can be concluded from these results t hat a good neurological outcome (Glasgow Outcome Scale = I) does not e xclude persisting neuropsychological deficits. Therefore, the value of the clinical use of the Glasgow Outcome Scale is limited. As a conseq uence, a differentiated neuropsychological examination is proposed to evaluate the exact outcome of SAH patients.