A prospective study of impairment of cognition and memory and recovery after subarachnoid hemorrhage

Neurosurgery. 1993 Oct;33(4):572-86; discussion 586-7. doi: 10.1227/00006123-199310000-00004.


In this prospective study, a series of 89 patients with subarachnoid hemorrhage (SAH), most of whom had a "good" neurological outcome, were assessed with a range of tests of memory and cognition as inpatients and at 10 weeks and 12 months after SAH. On tests of verbal cognition and memory, most patients had scores in the normal range 12 months after SAH. However, a significant number of patients still showed impairment on tests of visuospatial construction and memory, mental flexibility, and psychomotor speed at the 12-month assessment. Statistical analyses were carried out for each test score to see whether aneurysm site, location of blood on the admission computed tomographic scan, vasospasm, ischemia, hydrocephalus, grades at admission to and at discharge from hospital, and Glasgow Outcome Scale score at follow-up were associated with test scores. Aneurysm site was not shown to be associated with performance on any test at any time, and the other complications of SAH had only minimal predictive value. The grade at discharge proved to be the best predictor of impairment of cognition and memory at both follow-up assessments. Older subjects did not recover to the same extent as younger subjects by the 12-month assessment. The authors conclude that the diffuse effects of SAH are more important than focal neuropathology in relation to cognitive impairment in this group of patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amnesia / diagnosis*
  • Amnesia / psychology
  • Aneurysm, Ruptured / complications
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / psychology
  • Attention / physiology
  • Brain Damage, Chronic / diagnosis*
  • Brain Damage, Chronic / psychology
  • Brain Mapping
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / psychology
  • Disability Evaluation
  • Dominance, Cerebral / physiology
  • Female
  • Follow-Up Studies
  • Humans
  • Intelligence / physiology
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / psychology
  • Ischemic Attack, Transient / complications
  • Ischemic Attack, Transient / diagnosis
  • Ischemic Attack, Transient / psychology
  • Male
  • Mental Recall / physiology
  • Middle Aged
  • Neurocognitive Disorders / diagnosis*
  • Neurocognitive Disorders / psychology
  • Neuropsychological Tests / statistics & numerical data*
  • Prospective Studies
  • Psychometrics
  • Retrospective Studies
  • Subarachnoid Hemorrhage / complications*
  • Subarachnoid Hemorrhage / diagnosis
  • Subarachnoid Hemorrhage / psychology