Neuropsychological sequelae of aneurysmal sub-arachnoid haemorrhage in patients without neurological deficits 6 to 8 months post operatively : an exploratory study

• Main Author: Burbach, Frank Robert
• Other Authors: Jordan, Ann
• Format: Dissertation
• Language: English
• Published: University of Cape Town 2016
• Subjects: Clinical Psychology
• Online Access: http://hdl.handle.net/11427/16400

Bibliography: pages i-vii. === Relatively little is known about the neuropsychological sequelae of sub-arachnoid haemorrhage (SAH) and to date, there has only been one study (Ljunggren et al, 1985) focussing on patients without neurological deficits after aneurysm surgery for major SAH. A detailed exploratory study was designed to investigate the physical, cognitive, emotional, personality and behavioural sequelae of SAH in this group of patients. Neuropsychological sequelae were investigated in terms of a wide range of variables which could affect prognosis, viz location of aneurysm, timing of surgery, severity of the initial bleed, age, gender, educational level and estimated premorbid intelligence. An opportunity sample (N = 18) was drawn from patients treated at the Neurosurgery Department, Groote Schuur Hospital, Cape Town from May to November 1986. Patients were assessed 6.1 to 8.0 months post-operatively (mean 7.0 months) by means of an extensive neuropsychological test battery. A detailed structured interview was also conducted with the patient and somebody who was familiar with the patient's everyday functioning. Subjects ranged in age from 17 to 67 years (mean 38.8 years) and had a mean educational level of Standard 6 (range 2-10). Results were analysed in terms of the total sample and then according to successive subdivisions of subjects, on the basis of prognostic variables. The incidence and severity of symptoms ascribed to SAH are reported. Test data was interpreted in terms of two complementary psychometric theories (cognitive fall-off, and specific cognitive ability models). Results of the various aspects of the assessment were integrated in terms of ratings of general functional outcome. A diffuse SAH-induced encephalopathy was detected, which confirmed the findings of Ljunggren et al (1985). Impairment in functional ability was present in 61% of the sample. Similarities were noted with the Ljunggren et al (1985) study in terms of the cognitive abilities that were impaired, as well as the physical, personality and Differences in emotional, behavioural symptoms that were reported. studies are critically interpretation discussed and between the implications two for rehabilitation based examined. prognostic study with Further, variables regard on integrated functional assessment are tentative findings on the effects of are reported. The implications of this to neuropsychological assessment and further research are discussed.