Recovery of neuropsychological functioning after subarachnoid hemorrhage.
Item
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Title
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Recovery of neuropsychological functioning after subarachnoid hemorrhage.
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Identifier
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AAI3127908
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identifier
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3127908
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Creator
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Peery, Shelley.
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Contributor
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Adviser: Joan C. Borod
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Date
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2004
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Cognitive | Psychology, Psychometrics | Health Sciences, Rehabilitation and Therapy
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Abstract
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Background. This study examined the effect of demographic and clinical variables on recovery of neuropsychological functioning after subarachnoid hemorrhage (SAH). Methods. Patients admitted from July 1996 to March 2000 to the Neurosciences Intensive Care Unit at Columbia Presbyterian Medical Center with spontaneous SAH were consecutively enrolled into the study. Exclusion criteria included SAH from arteriovenous malformation, SAH more than 14 days prior to admission to the hospital, and age less than 18 years. During this period, 339 patients met criteria. The average age of the patients in the study group was 51.0 +/- 13.3 years, with a range from 19 to 87 years old. Informed consent was obtained at the time of study enrollment from all patients or a surrogate if the patient was incapacitated as determined by a study neurologist. Interviews with patients and/or their families were completed to obtain background information. Medical condition and hospital course, including disease severity and complications, were recorded prospectively. Demographics including age, sex, race/ethnicity, primary language, handedness, and years of education were obtained during the initial interview with the patient and/or family members. These variables were also verified in each follow-up interview. Three months and 12 months after the date of the SAH, subjects were invited to complete a comprehensive neuropsychological battery in the patient's preferred language, either English or Spanish, administered by a trained psychometrician. Seven cognitive domains and a measure of overall cognition were assessed including attention/concentration, psychomotor speed, visuospatial skills, language skills, verbal memory, visual memory, executive functions, and. The results indicated that psychomotor speed and attention recovered over time. Global mental status measured at 3 months after SAH showed the strongest relationship with neuropsychological functioning after SAH. Factors that contributed to greater cognitive impairment after SAH included older age, anterior aneurysm location, amount and location of blood, infarctions, cerebral edema, worse clinical grade, male sex, and not speaking English, but not vasospasm alone. Multiple variables contributed to the role of aneurysm location in cognition after SAH. Findings are discussed in relation to current literature.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
