Cognitive and Psychosocial outcomes after Aneurysmal Subarachnoid Hemorrhage

Abstract

A subarachnoid hemorrhage is a bleeding in the space around the brain. In a part of the cases, the bleeding is caused by a rupture of a bulge in a blood vessel, also called an aneurysm (aSAH). It is a life-threatening condition; only two third of the patients survives an aSAH. Although most of the survivors of an aSAH show good physical recovery, a lot of these patients cannot regain their pre-morbid level of functioning completely. ASAH patients often have cognitive impairments, for example in memory functions or concentration. But also, symptoms of depression, anxiety or posttraumatic stress are often present after aSAH. In the thesis “Cognitive and psychosocial outcomes after aneurysmal subarachnoid hemorrhage”, factors related to cognitive and psychosocial complaints and impairments are studied. The thesis shows that the amount of blood flow directly after the aSAH, cannot explain cognitive impairments after aSAH. Instead, neurological complications after aSAH, such as small infarctions ín the brain or an increase in brain fluid (hydrocephalus) play a (little) role. Cognitive complaints and anxiety after aSAH appear to have large impact on the level of restrictions patients experience in resuming their role in family, relationships with family or friends and participation in the society (social participation) after aSAH. Findings of the thesis help to better understand and predict which problems survivors of an aSAH with good physical recovery are faced with in daily life. Moreover, it demonstrates the importance for rehabilitation care after aSAH to evaluate cognitive and emotional functioning.