Hütter B O, Gilsbach J M, Kreitschmann I
Department of Neurosurgery, Technical University (RWTH) Aachen, Federal Republic of Germany.
Acta Neurochir (Wien). 1994;127(3-4):129-35. doi: 10.1007/BF01808755.
In a retrospective follow-up study 38 patients with aneurysmal subarachnoid haemorrhage (SAH) and 20 patients without an angiographically proven source of SAH were tested neuropsychologically one to five years after the acute event. All patients were operated on early within 72 hours if an aneurysm was proven angiographically and all were treated with nimodipine. Both patient groups had comparable cognitive deficits in spite of the less severe SAH of non-aneurysmal origin. Only in two cognitive functions the groups differed significantly. The patients after non-aneurysmal SAH had a significantly lower mean in the IQ subtest similarities finding (p < 0.05), while the patients after aneurysmal SAH had a significantly lower mean in a test of visual cognition (p < 0.05). A more detailed analysis with clinically homogeneous subgroups was additionally performed. The results showed in the subgroup with poor clinical grades that patients with aneurysmal SAH were significantly more disturbed in focal cognitive functions like short- and long-term memory and word-finding capacity, while patients with SAH of unknown origin scored significantly worse in a neuropsychological test related to attention, which can be regarded as a more diffuse cognitive function.
在一项回顾性随访研究中,对38例动脉瘤性蛛网膜下腔出血(SAH)患者和20例血管造影未证实有SAH来源的患者在急性事件发生后1至5年进行了神经心理学测试。如果血管造影证实有动脉瘤,所有患者均在72小时内尽早接受手术,并且所有患者均接受尼莫地平治疗。尽管非动脉瘤性起源的SAH病情较轻,但两组患者的认知缺陷相当。只有在两项认知功能上,两组存在显著差异。非动脉瘤性SAH患者在智商子测试相似性结果中的平均分显著较低(p<0.05),而动脉瘤性SAH患者在视觉认知测试中的平均分显著较低(p<0.05)。此外,还对临床特征相似的亚组进行了更详细的分析。结果显示,在临床分级较差的亚组中,动脉瘤性SAH患者在短期和长期记忆以及找词能力等局灶性认知功能方面的障碍明显更严重,而病因不明的SAH患者在与注意力相关的神经心理学测试中的得分明显更差,注意力可被视为一种更弥散的认知功能。