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Cognitive, mood and sleep impairment in aneurysmal subarachnoid hemorrhages
EANS Academy. Khan J. 09/25/19; 275667; EP01025
Jessica Khan
Jessica Khan

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Abstract
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Objectives: Aneurysmal subarachnoid hemorrhage (aSAH) is known to cause long-term disability in survivors, but there is a limited number of studies that have analyzed the consequences of aSAH on cognition, mood and sleep.
Materials and methods: Clinical data of 533 patients with aSAH treated (between year 2010 to 2018) in the Department of Neurosurgery, Pauls Stradins Clinical Hospital, was collected and the patients were invited for examination. 25 patients (68% females) participated in the interview with tests including Montreal Cognitive Assessment (MoCA), Mini Mental State Examination (MMSE), Hospital Anxiety (HADS-A) and Depression Scale (HADS-D), Beck Depression Inventory (DBI), Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS) and Insomnia Severity Index (ISI). The control group was age matched and consisted of 20 patients (60% females) without any expected neurovascular disorders. Pearson's correlation coefficient (PCC) was used to determine strength of associations.
Results: Altered MMSE score was found in 12%, and 36% had abnormal MoCA score. However, abnormal MoCA score was more expected in patients with SAH of Fisher Grade 4. Mild to severe insomnia was present in 40%, against 45% in controls. 40% of patients had abnormal sleep, against 15% in controls. 44% experienced fatigue, against 50% in controls. Nevertheless, a negative correlation was found between WFNS and ESS (PCC, [r] = -0.609, P < 0.05). 32% had mild to moderate mood disturbances according to BDI, against 30% in controls. 12% had abnormal both HADS-D and HADS-A, against 5% respectively 20% in controls.
Conclusion: Abnormal sleep and depression are the main issues among cognitive, mood and sleep impairments, suggesting improved outcome if measures taken to prevent. However, a large-scale study should be carried out to further clarify the issue.
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