Rollnik Jens D, Adner Anna
Institut für neurorehabilitative Forschung (InFo), Medizinische Hochschule Hannover, BDH-Klinik Hess. Oldendorf gGmbH.
Klinische Neuropsychologie, BDH-Klinik Hessisch Oldendorf gGmbH.
Fortschr Neurol Psychiatr. 2020 Jan;88(1):33-39. doi: 10.1055/a-1003-6756. Epub 2020 Jan 27.
The present review focuses on cognitive and participation impairments after aneurysmal subarachnoidal hemorrhage (aSAH). Such impairments may be present even in cases without evidence of damage in the neuropsychologically expected brain area. Neuroinflammation and oxidative stress may be responsible for this finding. Most frequently, cognitive impairment can be found in the verbal memory domain, visuospatial skills and memory domain, attention and working memory domain, executive functions (planning, central control, problem solving, attention, decision making), psychomotor speed and language domain. The presence of cognitive deficits is a major risk factor not to return to work again. Together with cognitive impairment, psychiatric symptoms like anxiety, depression and fatigue may be observed. Psychiatric disturbances result in impairments of social and vocational participation and - consecutively - worsening of quality of life.
本综述聚焦于动脉瘤性蛛网膜下腔出血(aSAH)后的认知和参与功能障碍。即使在神经心理学预期的脑区没有损伤证据的情况下,此类功能障碍也可能存在。神经炎症和氧化应激可能是这一现象的原因。最常见的是,认知功能障碍可出现在言语记忆领域、视觉空间技能和记忆领域、注意力和工作记忆领域、执行功能(计划、中央控制、问题解决、注意力、决策)、心理运动速度和语言领域。认知缺陷的存在是无法再次重返工作岗位的主要风险因素。除认知功能障碍外,还可能观察到焦虑、抑郁和疲劳等精神症状。精神障碍会导致社会和职业参与功能受损,并进而导致生活质量下降。