gms | German Medical Science

71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

The Neuropsychological Assessment Battery (NAB) is a valuable tool for evaluating neuropsychological outcome after aneurysmatic subarachnoid haemorrhage

Die Neuropsychological Assessment Battery (NAB) ist ein wertvolles Untersuchungstool zur Evaluation des neuropsychologischen Outcomes nach aneurysmatischer Subarachnoidalblutung

Meeting Abstract

  • presenting/speaker Johannes Walter - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Martin Grutza - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Lidia Vogt - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Andreas W. Unterberg - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Klaus Zweckberger - Universitätsklinikum Heidelberg, Neurochirurgie, Heidelberg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP084

doi: 10.3205/20dgnc371, urn:nbn:de:0183-20dgnc3718

Published: June 26, 2020

© 2020 Walter et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Detecting and treating neuropsychological deficits after aneurysmatic subarachnoid hemorrhage (aSAH) play a key role in regaining independence; however, detecting subtle deficits has been difficult and optimal timing of assessments remains unclear. Therefore, we evaluated the feasibility of administering the Neuropsychological Assessment Battery screening module (NAB-S) to patients with aSAH and characterized clinical as well as neuropsychological recovery over 24 months.

Methods: A total of 72 consecutive patients treated for aSAH were recruited. After acute treatment, follow up visits were conducted at 3, 12 and 24 months after hemorrhage. NAB-S, Montreal Cognitive Assessment (MoCA) and physical examination were performed at each follow up visit. Neuropsychological follow up was only scheduled if patients were able to understand and follow simple commands. Otherwise, outcome parameters (i.e. Extended Glasgow Outcome Score (GOSE) and Modified Rankin Score (mRS)) were assessed via telephone interview.

Results: The NAB-S could be administered to 40.0%, 77.8% and 94.1% of the patients at 3, 12 and 24 months, respectively. Severe impairment of one or more neuropsychological domains (e.g executive function, etc.) significantly correlated with inability to return to work at 12 months. Moderate impairment of two or more domains significantly correlated with poor outcome assessed by GOSE at 3 and 12 months. The number of patients with favorable outcomes increased from 30.9% to 36.8% and 46.7% at discharge, 3 and 12 months, respectively, and significantly increased to 87.5% after 24 months.

Conclusion: The NAB-S can be administered to the majority of patients with aSAH and can effectively detect clinically relevant neuropsychological deficits. Clinical recovery after aSAH continues for at least 24 months after the hemorrhage which should be considered in the design of future clinical trials.