gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Clinical assessment of deficits after SAH – about hasty neurosurgeons and accurate neurologists

Meeting Abstract

  • C. Fung - Universitätsklinik für Neurochirurgie, Universitätsspital Bern, Bern, Schweiz
  • J. Beck - Universitätsklinik für Neurochirurgie, Universitätsspital Bern, Bern, Schweiz
  • L. Lauber - Universitätsklinik für Neurochirurgie, Universitätsspital Bern, Bern, Schweiz
  • A. Raabe - Universitätsklinik für Neurochirurgie, Universitätsspital Bern, Bern, Schweiz
  • T. Nyffeler - Universitätsklinik für Neurologie, Universitätsklinik Bern, Bern Schweiz

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.08.09

doi: 10.3205/12dgnc234, urn:nbn:de:0183-12dgnc2342

Published: June 4, 2012

© 2012 Fung et al.
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Outline

Text

Objective: For survivors of aneurismal subarachnoid haemorrhage (SAH), somatic and cognitive deficits can affect long-term outcomes. Although patients may reach functional independence, many patients show cognitive or somatic impairment. Often neurosurgeons are responsible for recognizing these deficits and referring patients to rehabilitation. We were interested in comparing the deficits identified in SAH patients, including cognitive, at discharge by neurosurgeons and deficits identified by neurologists upon admission to the rehabilitation unit on the same day. The assessment of deficits might have an impact on referring patients to rehabilitation or detaining them of further treatment.

Methods: This retrospective study included 494 SAH patients treated between 2005–2010. Of these, 50 patients were discharged to an affiliated rehabilitation unit. Deficits were grouped into 18 categories and summarized into three groups: major somatic, minor somatic and cognitive deficits.

Results: Major somatic deficits were identified in 16 and 20 patients (P = 0.53), minor somatic deficits in 16 and 44 (P < 0.0001) patients and cognitive deficits in 36 and 45 (P < 0.04) by neurosurgeons and neurologists, respectively. Absolute number of major somatic deficits were 21 and 31 (P = 0.2), minor somatic deficits 18 and 97 (P < 0.0001) and cognitive deficits 61 and 147 (P < 0.0001), respectively.

Conclusions: Significant differences in assessment of cognitive and minor somatic deficits between neurosurgeons and neurologists exist. The awareness that minor somatic and cognitive deficits seem to be highly prevalent and especially cognitive deficits have a high impact on outcome needs to be improved. We emphasize the need to routinely assess cognitive deficits using a highly standardized, fast, and simple assessment tool that should be implemented in neurosurgical practice.