OBJECTIVES Patients with aneurysmal subarachnoid hemorrhage (aSAH) often sustain substantial cognitive and functional impairment. Traditional outcome measures have emphasized radiographic and gross clinical outcomes, but cognitive and functional outcomes are less frequently documented. This pilot study assessed the feasibility of administering longitudinal cognitive and neuropsychological testing and tracked patterns of functional improvement in aSAH patients. PATIENTS AND METHODS Standardized cognitive and neuropsychological testing were administered to a prospective cohort of aSAH patients admitted for treatment to our tertiary care center. Thirty consecutive aSAH patients (Hunt and Hess score 1-3) were enrolled over 23-months and baseline evaluations were completed within 24-h after admission. Patients were followed prospectively after treatment (coiling or clipping) at 1-, 3-, 6-, and 12-months. Functional outcome measures included the Montreal Cognitive Assessment, the Neuropsychiatric Inventory-Questionnaire, and the Functional Activities Questionnaire. RESULTS Of the 30 patients, 23 (77%) followed-up at 3-months, 21 (70%) at 6-months, and 19 (63%) at 12-months. Improvement from baseline to follow-up at 12-months was noted for general cognitive function (p = .004), memory (p = .025), and executive function (p = .039), with the greatest improvement occurring within 6-months. Daily function also improved mostly within 6-months (p = .022) while changes in neuropsychological disturbances were insignificant from baseline to follow-up at 12-months (p = .216). CONCLUSION Standardized cognitive and neuropsychological testing provides metrics for evaluating functional outcomes following treatment of aSAH. The addition of a brief battery of tests to routine clinical and radiographic evaluations is feasible. The main limitations are related to practice and referral patterns, and future studies are needed to evaluate the impact of treatment modalities on functional outcomes.

中文翻译：

---

动脉瘤性蛛网膜下腔出血：使用纵向认知和神经心理学测试功能结果的初步研究

目的 动脉瘤性蛛网膜下腔出血 (aSAH) 患者通常存在严重的认知和功能障碍。传统的结果测量强调放射学和总体临床结果，但很少记录认知和功能结果。该试点研究评估了在 aSAH 患者中进行纵向认知和神经心理学测试的可行性，并跟踪功能改善的模式。患者和方法 我们对进入我们三级医疗中心接受治疗的 aSAH 患者的前瞻性队列进行了标准化的认知和神经心理学测试。在 23 个月内连续招募了 30 名 aSAH 患者（Hunt 和 Hess 评分 1-3），并在入院后 24 小时内完成基线评估。在 1、3、6 和 12 个月的治疗（卷曲或夹闭）后对患者进行前瞻性随访。功能结果测量包括蒙特利尔认知评估、神经精神病学清单问卷和功能活动问卷。结果 在 30 名患者中，23 名 (77%) 在 3 个月时进行了随访，21 名 (70%) 在 6 个月时进行了随访，19 名 (63%) 在 12 个月时进行了随访。从基线到 12 个月的随访，一般认知功能 (p = .004)、记忆力 (p = .025) 和执行功能 (p = .039) 都有改善，其中最大的改善发生在 6-个月。日常功能也大部分在 6 个月内得到改善 (p = .022)，而神经心理障碍的变化从基线到 12 个月的随访并不显着 (p = .216)。结论标准化的认知和神经心理学测试提供了评估 aSAH 治疗后功能结果的指标。在常规临床和放射学评估中添加一组简短的测试是可行的。主要限制与实践和转诊模式有关，需要未来的研究来评估治疗方式对功能结果的影响。