Yoo Seung Don, Kim Dong Hwan, Kim Gook Ki, Bark Jihea
Department of Physical Medicine & Rehabilitation, College of Medicine, Kyung Hee University, Seoul 134-727, Korea.
Ann Rehabil Med. 2011 Oct;35(5):680-6. doi: 10.5535/arm.2011.35.5.680. Epub 2011 Oct 31.
To evaluate characteristics of cognitive impairments according to the location of aneurysmal subarachnoid hemorrhage (SAH) using a computerized neuropsychological test (CNT).
A total of 211 patients were transferred to our rehabilitation department after becoming neurologically stable following aneurysmal SAH. Twenty four of the 211 patients met the inclusion criteria and participated in a screening test using the mini-mental state examination (MMSE). Twenty patients with a MMSE score <26 were followed prospectively with a CNT and Beck depression inventory (BDI). Eleven patients had anterior communicating artery (ACoA) aneurysms and the other 9 had middle cerebral, internal carotid or posterior communicating artery aneurysms.
There were no differences in age, education, Hunt and Hess grade, or Fisher grade between the patients with ACoA aneurysmal SAH compared to patients with other aneurysmal SAH. In patients with ACoA aneurysmal SAH, scores of BDI (p=0.020), verbal learning test were lower than those of other aneurysmal SAH patients. In contrast, patients with non-ACoA aneurysmal SAH took significantly more time in auditory (p=0.025) and visual continuous performance tests (p=0.028). The cognitive deficit following aneurysmal SAH could be characterized by its location using CNT.
Using CNT in aneurysmal SAH patients could be a useful tool for evaluating the characteristics of cognitive impairment and planning rehabilitation programs according to each characteristic.
使用计算机化神经心理测试(CNT)评估根据动脉瘤性蛛网膜下腔出血(SAH)部位的认知障碍特征。
211例动脉瘤性SAH患者神经功能稳定后转入我们的康复科。211例患者中有24例符合纳入标准,并参加了简易精神状态检查(MMSE)筛查测试。对20例MMSE评分<26分的患者进行前瞻性CNT和贝克抑郁量表(BDI)随访。11例患者患有前交通动脉(ACoA)动脉瘤,另外9例患有大脑中动脉、颈内动脉或后交通动脉瘤。
ACoA动脉瘤性SAH患者与其他动脉瘤性SAH患者在年龄、教育程度、Hunt和Hess分级或Fisher分级方面无差异。在ACoA动脉瘤性SAH患者中,BDI评分(p=0.020)、言语学习测试得分低于其他动脉瘤性SAH患者。相比之下,非ACoA动脉瘤性SAH患者在听觉(p=0.025)和视觉持续操作测试中花费的时间明显更长(p=0.028)。使用CNT可以根据动脉瘤性SAH后的认知缺陷部位进行特征描述。
在动脉瘤性SAH患者中使用CNT可能是评估认知障碍特征并根据每个特征制定康复计划的有用工具。