A. Germano et al., DOES SUBARACHNOID BLOOD EXTRAVASATION PER SE INDUCE LONG-TERM NEUROPSYCHOLOGICAL AND COGNITIVE ALTERATIONS, Acta neurochirurgica, 140(8), 1998, pp. 805-812
Although recent advances in medical and management strategies have red
uced the mortality and morbidity rates related to subarachnoid haemorr
hage (SAH), patients who survive a SAH may remain nevertheless affecte
d by persistent cognitive and neuropsychological disturbances. The pre
sence of these deficits has been attributed to the neurotoxic effects
of the widespread subarachnoid blood. To assess the long-term neuropsy
chological and cognitive outcome related to subarachnoid blood extrava
sation per se we evaluated 20 patients affected by an unknown origin s
ubarachnoid haemorrhage, and having SAH characteristics generally cons
idered predictive of a favourable outcome. Patients were enrolled afte
r a one-year interval from the initial insult, and were selected accor
dingly to a pre-designed protocol. We employed a complete battery of t
ests, assessing general cognitive and language functions, memory and c
onstruction ability, attention and vigilance, anxiety and depression.
The results were compared with normal reference values and with perfor
mances of a socio-demographically homogenous sample of control volunte
ers. This study did not evidence any significant long-term cognitive a
nd neuropsychological alteration after subarachnoid blood extravasatio
n. These results indicate that the presence of subarachnoid blood init
iate a number of secondary mechanisms of pathology.