Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations
Antoinette E Zweifel-Zehnder, Martin N Stienen, Christian Chicherio, Aline Studerus-Germann, Stefan Bläsi, Stefania Rossi, Klemens Gutbrod, Nicole Schmid, Valérie Beaud, Christian Mondadori, Peter Brugger, Leonardo Sacco, Rene Müri, Gerhard Hildebrandt, Jean-Yves Fournier, Emanuela Keller, Luca Regli, Javier Fandino, Luigi Mariani, Andreas Raabe, Roy Thomas Daniel, Michael Reinert, Thomas Robert, Bawarjan Schatlo, Philippe Bijlenga, Karl Schaller, Andreas U Monsch, Swiss SOS study group, Ali-Reza Fathi, Serge Marbacher, Hassen Kerkeni, Jehuda Soleman, Daniel Coluccia, Carl Muroi, Hiroki Danura, Jan-Karl Burkhardt, Oliver Bozinov, David Bervini, Rodolfo Maduri, Marc Levivier, Andrea Ferrari, Martin Seule, Michel Röthlisberger, Daniel Zumofen, Raphael Guzman, Daniel Schöni, Christian Fung, Jürgen Beck, Philippe Schucht, Daniele Valsecchi, Marta Arrighi, Dominque Emmanuelle Kuhlen, Marco V Corniola, Severin Früh, Antoinette E Zweifel-Zehnder, Martin N Stienen, Christian Chicherio, Aline Studerus-Germann, Stefan Bläsi, Stefania Rossi, Klemens Gutbrod, Nicole Schmid, Valérie Beaud, Christian Mondadori, Peter Brugger, Leonardo Sacco, Rene Müri, Gerhard Hildebrandt, Jean-Yves Fournier, Emanuela Keller, Luca Regli, Javier Fandino, Luigi Mariani, Andreas Raabe, Roy Thomas Daniel, Michael Reinert, Thomas Robert, Bawarjan Schatlo, Philippe Bijlenga, Karl Schaller, Andreas U Monsch, Swiss SOS study group, Ali-Reza Fathi, Serge Marbacher, Hassen Kerkeni, Jehuda Soleman, Daniel Coluccia, Carl Muroi, Hiroki Danura, Jan-Karl Burkhardt, Oliver Bozinov, David Bervini, Rodolfo Maduri, Marc Levivier, Andrea Ferrari, Martin Seule, Michel Röthlisberger, Daniel Zumofen, Raphael Guzman, Daniel Schöni, Christian Fung, Jürgen Beck, Philippe Schucht, Daniele Valsecchi, Marta Arrighi, Dominque Emmanuelle Kuhlen, Marco V Corniola, Severin Früh
Abstract
Background: In a high proportion of patients with favorable outcome after aneurysmal subarachnoid hemorrhage (aSAH), neuropsychological deficits, depression, anxiety, and fatigue are responsible for the inability to return to their regular premorbid life and pursue their professional careers. These problems often remain unrecognized, as no recommendations concerning a standardized comprehensive assessment have yet found entry into clinical routines.
Methods: To establish a nationwide standard concerning a comprehensive assessment after aSAH, representatives of all neuropsychological and neurosurgical departments of those eight Swiss centers treating acute aSAH have agreed on a common protocol. In addition, a battery of questionnaires and neuropsychological tests was selected, optimally suited to the deficits found most prevalent in aSAH patients that was available in different languages and standardized.
Results: We propose a baseline inpatient neuropsychological screening using the Montreal Cognitive Assessment (MoCA) between days 14 and 28 after aSAH. In an outpatient setting at 3 and 12 months after bleeding, we recommend a neuropsychological examination, testing all relevant domains including attention, speed of information processing, executive functions, verbal and visual learning/memory, language, visuo-perceptual abilities, and premorbid intelligence. In addition, a detailed assessment capturing anxiety, depression, fatigue, symptoms of frontal lobe affection, and quality of life should be performed.
Conclusions: This standardized neuropsychological assessment will lead to a more comprehensive assessment of the patient, facilitate the detection and subsequent treatment of previously unrecognized but relevant impairments, and help to determine the incidence, characteristics, modifiable risk factors, and the clinical course of these impairments after aSAH.
Source: PubMed