Early cognitive domain deficits in patients with aneurysmal subarachnoid hemorrhage correlate with functional status

Abstract

Objective: Cognitive deficits commonly occur after aneurysmal subarachnoid hemorrhage (aSAH), although a few studies systemically evaluate its early impact. We hypothesized that early cognitive domain deficits in patients with aSAH correlate with functional status. Methods: We carried out a prospective observational study in Hong Kong, for which patients with aSAH, aged 21-75 years, who had been admitted within 96 h of ictus were recruited. The cognitive assessment used was the domain-specific neuropsychological assessment battery at 2-4 weeks (n = 74) after ictus. Functional status was measured using the modified Rankin Scale (mRS) and the Lawton Instrumental Activity of Daily Living (IADL) scale. The study is registered at ClinicalTrials.gov of the US National Institutes of Health (NCT01038193). Results: Unfavorable outcome (mRS 3-5) was associated with visuospatial memory domain deficit and language domain deficit. Dependent IADL (score <15) was associated with language domain deficit. Interpretation: Visuospatial memory and language are important determinants of early functional status. Whether early targeted rehabilitation can improve functional status should be assessed in a future study.