DOES SUBARACHNOID BLOOD EXTRAVASATION PER SE INDUCE LONG-TERM NEUROPSYCHOLOGICAL AND COGNITIVE ALTERATIONS

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.