Long-term Neuropsychiatric and Neuropsychological Sequelae of Endovascularly Treated Aneurysmal Subarachnoid Hemorrhage
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894 |
Resumo: | Introduction: There is limited evidence regarding long-term outcomes of aneurysmal subarachnoid hemorrhage survivors. Most follow-up programs are relatively short and focused on physical functions. Endovascular aneurysmal embolization enables recovery of normal vascular architecture. However, there is growing evidence that neuropsychological and behavior sequelae can significantly impact the lives of these patients, even when treatment is successful. In this study, we reviewed cognition, psychiatric and neuropsychological symptoms, global functionality, and health-related quality of life 10 to 12 years after an aneurysmal subarachnoid hemorrhage.Material and Methods: A cross-sectional observational study was carried out in a university hospital. All cases of aneurysmal subarachnoid hemorrhage admitted between January 2004 and December 2006 and endovascularly treated were reviewed. Participants underwent a neuropsychological evaluation and a clinical interview with a psychiatrist.Results: Fourteen patients participated in the study. Almost 70% (n = 10) showed cognitive impairment; in more than 40% (n = 6) of the subjects, significant symptoms of anxiety were identified, and 35% (n = 5) were classified as having clinical depression. Relevant posttraumatic symptoms were reported by more than 70% (n = 10) of patients, and almost 30% (n = 4) showed other moderate neuropsychiatric symptoms. Overall, health-related quality of life was impaired, and personality changes were frequently reported by the participants and their relatives.Discussion: A significant prevalence of ongoing deficits in high-level functioning and reduced health-related quality of life were observed in a sample of young and professionally active individuals that were successfully treated and discharged from follow-up consultations.Conclusion: There is a need for better follow-up strategies, targeting more subtle deficits and psychological symptoms after aneurysmal subarachnoid hemorrhage. |
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Long-term Neuropsychiatric and Neuropsychological Sequelae of Endovascularly Treated Aneurysmal Subarachnoid HemorrhageSequelas Neuropsiquiátricas e Neuropsicológicas, a Longo Prazo, de Hemorragia Subaracnoideia Aneurismática Tratada EndovascularmenteActivities of Daily LivingEndovascular ProceduresMood DisordersSubarachnoid Cognitive DysfunctionSubarachnoid Hemorrhage/complicationsAtividades da Vida DiáriaHemorragia Subaracnoideia/complicaçõesPerturbações da CogniçãoPerturbações do HumorProcedimentos EndovascularesIntroduction: There is limited evidence regarding long-term outcomes of aneurysmal subarachnoid hemorrhage survivors. Most follow-up programs are relatively short and focused on physical functions. Endovascular aneurysmal embolization enables recovery of normal vascular architecture. However, there is growing evidence that neuropsychological and behavior sequelae can significantly impact the lives of these patients, even when treatment is successful. In this study, we reviewed cognition, psychiatric and neuropsychological symptoms, global functionality, and health-related quality of life 10 to 12 years after an aneurysmal subarachnoid hemorrhage.Material and Methods: A cross-sectional observational study was carried out in a university hospital. All cases of aneurysmal subarachnoid hemorrhage admitted between January 2004 and December 2006 and endovascularly treated were reviewed. Participants underwent a neuropsychological evaluation and a clinical interview with a psychiatrist.Results: Fourteen patients participated in the study. Almost 70% (n = 10) showed cognitive impairment; in more than 40% (n = 6) of the subjects, significant symptoms of anxiety were identified, and 35% (n = 5) were classified as having clinical depression. Relevant posttraumatic symptoms were reported by more than 70% (n = 10) of patients, and almost 30% (n = 4) showed other moderate neuropsychiatric symptoms. Overall, health-related quality of life was impaired, and personality changes were frequently reported by the participants and their relatives.Discussion: A significant prevalence of ongoing deficits in high-level functioning and reduced health-related quality of life were observed in a sample of young and professionally active individuals that were successfully treated and discharged from follow-up consultations.Conclusion: There is a need for better follow-up strategies, targeting more subtle deficits and psychological symptoms after aneurysmal subarachnoid hemorrhage.Introdução: As evidências sobre a evolução a longo prazo dos sobreviventes de uma hemorragia subaracnoideia aneurismática são relativamente limitadas. A maioria dos programas de follow-up têm uma curta duração e são focados principalmente nas funções motoras. Apesar da embolização aneurismática endovascular permitir uma recuperação da arquitetura vascular normal, há evidências crescentes de que certas sequelas neuropsicológicas e comportamentais podem afetar significativamente a vida desses pacientes, a longo prazo, mesmo quando o tratamento é bem-sucedido. Neste estudo, analisamos os sintomas cognitivos, psiquiátricos e neuropsicológicos, a funcionalidade global e a qualidade de vida relacionada com a saúde, 10 a 12 anos após uma hemorragia subaracnoideia aneurismática.Material e Métodos: Um estudo observacional, transversal, foi realizado num hospital universitário. Todos os casos de hemorragia subaracnoideia aneurismática, admitidos entre janeiro de 2004 e dezembro de 2006, tratados endovascularmente, foram revistos. Os participantes foram sujeitos a uma avaliação neuropsicológicas e a uma entrevista clínica com um psiquiatra.Resultados: Participaram no estudo 14 doentes. Cerca de 70% (n = 10) apresentavam compromisso cognitivo; em mais de 40% (n = 6) foram identificados sintomas significativos de ansiedade e 35% (n = 5) foram classificados como tendo depressão clínica. Sintomas de stress pós-traumático relevantes foram relatados por mais de 70% (n = 10) e quase 30% (n = 4) apresentavam sintomas neuropsiquiátricos moderados. Em geral, a qualidade de vida relacionada com o estado de saúde encontrava-se reduzida e relatos de alterações de personalidade foram frequentemente feitos pelos participantes e seus familiares.Discussão: Uma prevalência significativa de défices em altos níveis de funcionamento e uma redução da qualidade de vida relacionada com a saúde foi observada numa amostra de indivíduos jovens e profissionalmente ativos, que foram tratados com sucesso e tiveram alta das consultas de seguimento.Conclusão: São necessárias melhores estratégias de follow-up, visando défices cognitivos e sintomas psicológicos mais subtis, após uma hemorragia subaracnoideia aneurismática.Ordem dos Médicos2019-11-04info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/mswordapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894oai:ojs.www.actamedicaportuguesa.com:article/10894Acta Médica Portuguesa; Vol. 32 No. 11 (2019): November; 706-713Acta Médica Portuguesa; Vol. 32 N.º 11 (2019): Novembro; 706-7131646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894/5792https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894/10938https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894/10939https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894/11255https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894/11609Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessSousa, LídiaAntunes, AnaMendes, TiagoReimão, SofiaNeto, Lia LucasCampos, Jorge2022-12-20T11:06:06Zoai:ojs.www.actamedicaportuguesa.com:article/10894Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:57.542862Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Long-term Neuropsychiatric and Neuropsychological Sequelae of Endovascularly Treated Aneurysmal Subarachnoid Hemorrhage Sequelas Neuropsiquiátricas e Neuropsicológicas, a Longo Prazo, de Hemorragia Subaracnoideia Aneurismática Tratada Endovascularmente |
title |
Long-term Neuropsychiatric and Neuropsychological Sequelae of Endovascularly Treated Aneurysmal Subarachnoid Hemorrhage |
spellingShingle |
Long-term Neuropsychiatric and Neuropsychological Sequelae of Endovascularly Treated Aneurysmal Subarachnoid Hemorrhage Sousa, Lídia Activities of Daily Living Endovascular Procedures Mood Disorders Subarachnoid Cognitive Dysfunction Subarachnoid Hemorrhage/complications Atividades da Vida Diária Hemorragia Subaracnoideia/complicações Perturbações da Cognição Perturbações do Humor Procedimentos Endovasculares |
title_short |
Long-term Neuropsychiatric and Neuropsychological Sequelae of Endovascularly Treated Aneurysmal Subarachnoid Hemorrhage |
title_full |
Long-term Neuropsychiatric and Neuropsychological Sequelae of Endovascularly Treated Aneurysmal Subarachnoid Hemorrhage |
title_fullStr |
Long-term Neuropsychiatric and Neuropsychological Sequelae of Endovascularly Treated Aneurysmal Subarachnoid Hemorrhage |
title_full_unstemmed |
Long-term Neuropsychiatric and Neuropsychological Sequelae of Endovascularly Treated Aneurysmal Subarachnoid Hemorrhage |
title_sort |
Long-term Neuropsychiatric and Neuropsychological Sequelae of Endovascularly Treated Aneurysmal Subarachnoid Hemorrhage |
author |
Sousa, Lídia |
author_facet |
Sousa, Lídia Antunes, Ana Mendes, Tiago Reimão, Sofia Neto, Lia Lucas Campos, Jorge |
author_role |
author |
author2 |
Antunes, Ana Mendes, Tiago Reimão, Sofia Neto, Lia Lucas Campos, Jorge |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Sousa, Lídia Antunes, Ana Mendes, Tiago Reimão, Sofia Neto, Lia Lucas Campos, Jorge |
dc.subject.por.fl_str_mv |
Activities of Daily Living Endovascular Procedures Mood Disorders Subarachnoid Cognitive Dysfunction Subarachnoid Hemorrhage/complications Atividades da Vida Diária Hemorragia Subaracnoideia/complicações Perturbações da Cognição Perturbações do Humor Procedimentos Endovasculares |
topic |
Activities of Daily Living Endovascular Procedures Mood Disorders Subarachnoid Cognitive Dysfunction Subarachnoid Hemorrhage/complications Atividades da Vida Diária Hemorragia Subaracnoideia/complicações Perturbações da Cognição Perturbações do Humor Procedimentos Endovasculares |
description |
Introduction: There is limited evidence regarding long-term outcomes of aneurysmal subarachnoid hemorrhage survivors. Most follow-up programs are relatively short and focused on physical functions. Endovascular aneurysmal embolization enables recovery of normal vascular architecture. However, there is growing evidence that neuropsychological and behavior sequelae can significantly impact the lives of these patients, even when treatment is successful. In this study, we reviewed cognition, psychiatric and neuropsychological symptoms, global functionality, and health-related quality of life 10 to 12 years after an aneurysmal subarachnoid hemorrhage.Material and Methods: A cross-sectional observational study was carried out in a university hospital. All cases of aneurysmal subarachnoid hemorrhage admitted between January 2004 and December 2006 and endovascularly treated were reviewed. Participants underwent a neuropsychological evaluation and a clinical interview with a psychiatrist.Results: Fourteen patients participated in the study. Almost 70% (n = 10) showed cognitive impairment; in more than 40% (n = 6) of the subjects, significant symptoms of anxiety were identified, and 35% (n = 5) were classified as having clinical depression. Relevant posttraumatic symptoms were reported by more than 70% (n = 10) of patients, and almost 30% (n = 4) showed other moderate neuropsychiatric symptoms. Overall, health-related quality of life was impaired, and personality changes were frequently reported by the participants and their relatives.Discussion: A significant prevalence of ongoing deficits in high-level functioning and reduced health-related quality of life were observed in a sample of young and professionally active individuals that were successfully treated and discharged from follow-up consultations.Conclusion: There is a need for better follow-up strategies, targeting more subtle deficits and psychological symptoms after aneurysmal subarachnoid hemorrhage. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-11-04 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894 oai:ojs.www.actamedicaportuguesa.com:article/10894 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/10894 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894/5792 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894/10938 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894/10939 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894/11255 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10894/11609 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2019 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2019 Acta Médica Portuguesa |
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openAccess |
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application/pdf application/pdf application/pdf application/msword application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 32 No. 11 (2019): November; 706-713 Acta Médica Portuguesa; Vol. 32 N.º 11 (2019): Novembro; 706-713 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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