Cognitive Functioning and Health-Related Quality of Life 1 Year After Aneurysmal Subarachnoid Hemorrhage in Preoperative Comatose Patients (Hunt and Hess Grade V Patients)

DOI: 10.1227/01.NEU.0000365364.87303.AC

OBJECTIVE: The objective of this study was to determine cognitive functioning and health related quality of life one year after aneurysmal subarachnoid hemorrhage in preoperative comatose patients.

METHODS: Patients were investigated for one year using a comprehensive neuropsychological test battery and two HRQOL questionnaires.

RESULTS: Thirty-five of 70 patients survived the bleed, and 26 underwent neuropsychological testing. Two distinct patient groups emerged; one (n = 14) with good cognitive function, and the other (n = 12) with poor cognitive and motor function. Patients performing poorly were older (p = 0.04), had fewer years of education, (p = 0.005) larger preoperative ventricular scores, and were more often shunted (p = 0.02). There were also differences between the two groups in the Glasgow Outcome Scale (p = 0.001), modified Rankin Scale (p = 0.001), and employment status. HRQOL was more reduced in patients with poor cognitive function.

CONCLUSION: A high fraction of survivors among preoperative comatose aneurysmal SAH patients (Hunt and Hess grade V patients) recover to a good physical and cognitive function.

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