• George Kwok Chu Wong, Sandy Wai Lam, Karine Ngai, Adrian Wong, Deyond Siu, Wai Sang Poon, Vincent Mok, and Cognitive Dysfunction after Aneurysmal Subarachnoid Hemorrhage Investigators.
• Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. georgewong@surgery.cuhk.edu.hk
• J. Neurol. Neurosurg. Psychiatr.. 2013 Sep 1;84(9):1054-8.

BackgroundCognitive domain deficits can occur after aneurysmal subarachnoid haemorrhage (aSAH) though few studies systemically evaluate its impact on 1-year outcomes.ObjectiveWe aimed to evaluate the pattern and functional outcome impact of cognitive domain deficits in aSAH patients at 1 year.MethodsWe carried out a prospective observational study in Hong Kong, during which, 168 aSAH patients (aged 21-75 years and had been admitted within 96 h of ictus) were recruited over a 26-month period. The cognitive function was assessed by a domain-specific neuropsychological assessment battery at 1 year after ictus. The current study is registered at ClinicalTrials.gov of the US National Institutes of Health (NCT01038193).ResultsPrevalence of individual domain deficits varied between 7% to 15%, and 13% had two or more domain deficits. After adjusting for abbreviated National Institute of Health Stroke Scale and Geriatric Depressive Scale scores, unfavourable outcome (Modified Rankin Scale 3-5) and dependent instrumental activity of daily living (Lawton Instrumental Activity of Daily Living<15) were significantly associated with two or more domain deficits and number of cognitive domain deficits at 1 year. Two or more domain deficits was independently associated with age (OR, 1.1; 95% CI 1.1 to 1.2; p<0.001) and delayed cerebral infarction (OR, 6.1; 95% CI 1.1 to 33.5; p=0.036), after adjustment for years of school education.InterpretationIn patients with aSAH, cognitive domain deficits worsened functional outcomes at 1 year. Delayed cerebral infarction was an independent risk factor for two or more domain deficits at 1 year.

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