Department of Neurosurgery, National Brain Aneurysm & Tumor Center, United Hospital, Twin Cities, MN, USA.
Superior Medical Experts, St. Paul, MN, USA.
Br J Neurosurg. 2021 Aug;35(4):384-401. doi: 10.1080/02688697.2020.1859462. Epub 2020 Dec 21.
Subarachnoid hemorrhage (SAH) is associated with high rates of morbidity, including neurological and cognitive deficits that may be difficult to identify and quantify. This review provides an update on the cognitive deficits that may result from spontaneous aneurysmal SAH (aSAH) and identifies factors that may help predict and manage these deficits at discharge and thereafter.
We conducted a systematic review of PubMed and Google Scholar to identify studies published between 2010 and 2019 that assessed cognitive deficits at discharge and during follow-up in patients with aSAH. Full-text articles were assessed for information regarding cognitive testing and factors that may be associated with functional outcomes in this population.
We reviewed 65 studies published since 2010 that described the cognitive deficits associated with non-traumatic aSAH. Such deficits may impact functional outcomes, quality of life, and return to work and may result in cognitive impairments, such as memory difficulties, speech problems, and psychiatric disorders.
Patients with aSAH, even those that appear normal at the time of hospital discharge, may harbor cognitive deficits that are difficult to detect, yet can interfere with daily functioning. Further research is needed to provide additional information and to identify stronger correlations to be used in the identification, treatment, and amelioration of long-term cognitive deficits in aSAH patients, including those who are discharged with good clinical outcomes scores.
蛛网膜下腔出血（SAH）与高发病率相关，包括神经和认知缺陷，这些缺陷可能难以识别和量化。本综述提供了关于自发性脑动脉瘤性 SAH（aSAH）可能导致的认知缺陷的最新信息，并确定了可能有助于预测和管理出院后这些缺陷的因素。
我们对 PubMed 和 Google Scholar 进行了系统回顾，以确定 2010 年至 2019 年期间发表的评估 aSAH 患者出院时和随访期间认知缺陷的研究。评估全文文章中关于认知测试以及可能与该人群功能结果相关的因素的信息。
我们回顾了自 2010 年以来发表的 65 篇描述与非创伤性 aSAH 相关的认知缺陷的研究。这些缺陷可能会影响功能结果、生活质量和重返工作岗位，并且可能导致认知障碍，例如记忆困难、言语问题和精神障碍。
即使在出院时看起来正常的 aSAH 患者也可能存在难以察觉但会干扰日常功能的认知缺陷。需要进一步研究以提供更多信息，并确定更强的相关性，以便在识别、治疗和改善 aSAH 患者的长期认知缺陷（包括出院时临床结果评分良好的患者）中使用。
