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Table 5
Clinical trials oriented toward recognition of arteriographical aSAH
and vasospasm infl uence on neurobehavior
References
Leading cognitive dysfunction
Limitations
(
38
)
Moderate defi cit in free recall
Caveat: Retrospective, small
(
39
)
Free recall and short memory tests affected
anterior communicating artery (ACoA)
and vasospasm associated
Caveat: Retrospective, 2-14 years
after SAH
(
40
)
31% of amnesia in the acute phase
Caveat: Retrospective, small, 23% of
patient had the aneurysm trapped
(
41
)
Cognitive defects and frontal lobe syndrome
Caveat: Retrospective, small,
1-7 years after aSAH and 1/3
with hydrocephalus
(
42
)
The only prospective study; mild-to-moderate
cognitive and memory dysfunction at GOS (
5
)
Caveat: Neurobehavioral dysfunc-
tions unrelated to vasospasm,
ischemia, or hydrocephalus
(
43
)
65% of the patients were impaired in at least one
cognitive domain
Caveat: Retrospective, small
Table 6
Prognostic factors of neurobehavioral changes after aSAH
Factor
References
Initial Hunt and Hess score
(
43, 46, 47
)
Severity of bleeding
(
8, 43, 46
)
Intraparenchymal/intraventricular bleeding
(
42
)
Persistent neurological defi cits
(
48
)
Age at the time of aSAH
(
8, 42, 46, 47
)
surgical aneurysm repair can affect neurobehavior. Nevertheless, as
mentioned above, several factors beyond vasospasm have also been
linked to the neurobehavioral defi cits (Table
6
).
There are several important conclusions emerging from these
studies: (1) neuropsychological results predict the patient's ability
to resume work (
47
) and (2) the time frame of functional recovery
remains unclear (
44
). Other important fi ndings were (3) a signifi -
cant discrepancy between a GOS 5 and poor neuropsychological
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