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Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations

Zweifel-Zehnder, Antoinette ; Stienen, Martin ; Chicherio, Christian ; Studerus-Germann, Aline ; Bläsi, Stefan ; Rossi, Stefania ; Gutbrod, Klemens ; Schmid, Nicole ; Beaud, Valérie ; Mondadori, Christian ; Brugger, Peter ; Sacco, Leonardo ; Müri, Rene ; Hildebrandt, Gerhard ; Fournier, Jean-Yves ; Keller, Emanuela ; Regli, Luca ; Fandino, Javier ; Mariani, Luigi ; Raabe, Andreas ; Daniel, Roy ; Reinert, Michael ; Robert, Thomas ; Schatlo, Bawarjan ; Bijlenga, Philippe ; Schaller, Karl ; Monsch, Andreas

In: Acta Neurochirurgica, 2015, vol. 157, no. 9, p. 1449-1458

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    Titre
    • Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations
    Auteur
    • Zweifel-Zehnder, Antoinette. Division of Neuropaediatrics, Development, and Rehabilitation, Department of Paediatrics, Inselspital Bern, Bern, Switzerland
    • Stienen, Martin. Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland
    • Chicherio, Christian. Department of Neurology, Neuropsychology Unit, University Hospital Geneva, Geneva, Switzerland
    • Studerus-Germann, Aline. Neuropsychology Unit, Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland
    • Bläsi, Stefan. Memory Clinic, University Center for Medicine of Aging, Felix Platter-Hospital, Basel, Switzerland
    • Rossi, Stefania. Department of Neurology, Neuropsychology Unit, Ospedale Regionale di Lugano, Lugano, Switzerland
    • Gutbrod, Klemens. Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital Bern, Bern, Switzerland
    • Schmid, Nicole. Neuropsychology Unit, Department of Neurology, Kantonsspital Aarau, Aarau, Switzerland
    • Beaud, Valérie. Neuropsychology Unit, Clinical Neurosciences Department, CHUV, Lausanne, Switzerland
    • Mondadori, Christian. Neurological Rehabilitation, Rehaklinik Bellikon, Bellikon, Switzerland
    • Brugger, Peter. Neuropsychology Unit, Department of Neurology, University Hospital Zürich, Zürich, Switzerland
    • Sacco, Leonardo. Department of Neurology, Neuropsychology Unit, Ospedale Regionale di Lugano, Lugano, Switzerland
    • Müri, Rene. Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital Bern, Bern, Switzerland
    • Hildebrandt, Gerhard. Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
    • Fournier, Jean-Yves. Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
    • Keller, Emanuela. Department of Neurosurgery, University Hospital Zürich, Zürich, Switzerland
    • Regli, Luca. Department of Neurosurgery, University Hospital Zürich, Zürich, Switzerland
    • Fandino, Javier. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland
    • Mariani, Luigi. Department of Neurosurgery, University Hospital Basel, Basel, Switzerland
    • Raabe, Andreas. Department of Neurosurgery, Inselspital Bern, Bern, Switzerland
    • Daniel, Roy. Department of Neurosurgery, CHUV, Lausanne, Switzerland
    • Reinert, Michael. Department of Neurosurgery, Ospedale Regionale di Lugano, Lugano, Switzerland
    • Robert, Thomas. Department of Neurosurgery, Ospedale Regionale di Lugano, Lugano, Switzerland
    • Schatlo, Bawarjan. Department of Neurosurgery, Georg-August University, University Medicine Göttingen, Göttingen, Germany
    • Bijlenga, Philippe. Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland
    • Schaller, Karl. Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland
    • Monsch, Andreas. Memory Clinic, University Center for Medicine of Aging, Felix Platter-Hospital, Basel, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:330980
    Summary
    Background: In a high proportion of patients with favorable outcome after aneurysmal subarachnoid hemorrhage (aSAH), neuropsychological deficits, depression, anxiety, and fatigue are responsible for the inability to return to their regular premorbid life and pursue their professional careers. These problems often remain unrecognized, as no recommendations concerning a standardized comprehensive assessment have yet found entry into clinical routines. Methods: To establish a nationwide standard concerning a comprehensive assessment after aSAH, representatives of all neuropsychological and neurosurgical departments of those eight Swiss centers treating acute aSAH have agreed on a common protocol. In addition, a battery of questionnaires and neuropsychological tests was selected, optimally suited to the deficits found most prevalent in aSAH patients that was available in different languages and standardized. Results: We propose a baseline inpatient neuropsychological screening using the Montreal Cognitive Assessment (MoCA) between days 14 and 28 after aSAH. In an outpatient setting at 3 and 12months after bleeding, we recommend a neuropsychological examination, testing all relevant domains including attention, speed of information processing, executive functions, verbal and visual learning/memory, language, visuo-perceptual abilities, and premorbid intelligence. In addition, a detailed assessment capturing anxiety, depression, fatigue, symptoms of frontal lobe affection, and quality of life should be performed. Conclusions: This standardized neuropsychological assessment will lead to a more comprehensive assessment of the patient, facilitate the detection and subsequent treatment of previously unrecognized but relevant impairments, and help to determine the incidence, characteristics, modifiable risk factors, and the clinical course of these impairments after aSAH.