Cognitive and Functional Outcome After Aneurysmal Subarachnoid Hemorrhage
Cognitive and Functional Outcome After Aneurysmal Subarachnoid Hemorrhage
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DOI：
10.1161/strokeaha.110.581975
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发表时间：
2010-08-01
期刊：
影响因子：
8.3
通讯作者：
Schweizer, Tom A.
中科院分区：
文献类型：
--
作者：
Al-Khindi, Timour;Macdonald, R. Loch;Schweizer, Tom A.
背景与目的：动脉瘤性蛛网膜下腔出血（aSAH）是一种以脑周围蛛网膜下腔积血为特征的医学急诊。aSAH的急性治疗有很好的文献记载，但对aSAH对认知和日常功能的长期影响知之甚少。方法：我们回顾了过去10年来所有关注aSAH对认知和日常功能影响的研究。结果：61项关于aSAH患者认知和功能结局的实证研究符合纳入标准。aSAH的幸存者通常经历记忆、执行功能和语言方面的缺陷。这些认知障碍相互作用影响患者的日常功能，包括日常生活活动、日常生活工具活动、重返工作岗位和生活质量。认知和日常功能的缺陷因抑郁、焦虑、疲劳和睡眠障碍而进一步恶化。结论：关于认知和功能缺陷背后的大脑变化，包括弥漫性脑损伤和继发并发症如血管痉挛和颅内压升高的作用，还有很多有待研究。考虑这些问题是必要的，以便更好地了解aSAH如何长期影响认知和日常功能。[中国中风杂志];2010;41:e519-e536.]
Background and Purpose-Aneurysmal subarachnoid hemorrhage (aSAH) is a medical emergency characterized by the accumulation of blood in the subarachnoid space surrounding the brain. The acute treatment of aSAH is well documented but less is known about the long-term effects of aSAH on cognition and day-to-day functioning.Methods-We reviewed all studies in the past 10 years that have focused on the effects of aSAH on cognition and day-to-day functioning.Results-Sixty-one empirical studies examining cognitive and functional outcome in patients with aSAH met inclusion criteria. Survivors of aSAH commonly experience deficits in memory, executive function, and language. These cognitive impairments interact to affect patients' day-to-day functioning, including activities of daily living, instrumental activities of daily living, return to work, and quality of life. Deficits in cognition and day-to-day functioning are further compounded by depression, anxiety, fatigue, and sleep disturbances.Conclusions-Much remains to be learned about the brain changes underlying cognitive and functional deficits, including the role of diffuse brain damage and secondary complications like vasospasm and elevated intracranial pressure. A consideration of these issues is necessary to obtain a better understanding of how aSAH affects cognition and day-to-day functioning in the long-term. (Stroke. 2010; 41: e519-e536.)