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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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