Neurological and psychosocial outcome 4 to 7 years after subarachnoid hemorrhage.
OBJECTIVE
Previous studies have demonstrated that many patients with good neurological outcomes still experience excessive fatigue, cognitive impairments, and lowered work status 1 year after subarachnoid hemorrhage (SAH). Does recovery continue for many years or are survivors of SAH left with permanent disabilities? We describe the long-term outcome.


METHODS
Approximately 50% (n = 123) of the patients who survived SAH for more than 3 years from a population of 1.5 million and who had participated in research studies at the time of their SAH were interviewed 4 to 7 years later by telephone or questionnaire. Participants did not differ from the 126 unsurveyed survivors in age, gender, SAH grades, aneurysm sites, or complications.


RESULTS
Most patients thought their recovery to be satisfactory to good, although some reported memory problems (41%), headaches (16.5%), daytime sleepiness (35%), problems sleeping at night (26%), a reduced ability to work (20%), and a changed personality (48.3%). Many had reduced their smoking and drinking. Each of 24 of the 121 participants for whom seizure data were available (all with clipped aneurysms) had suffered at least one seizure, but only each of 10 had suffered two or more seizures since hospital discharge. Relative youth was the only significant predictor of seizures, with strong trends observed between seizures and a poor Glasgow Outcome Scale score at 10 weeks or between seizures and an ischemic neurological deficit. No evidence for the effectiveness of prophylactic anticonvulsants was demonstrated.


CONCLUSIONS
Survivors of SAH continue to recover for years and develop good coping skills and a positive attitude toward their recovery, even when they experience ongoing problems. Few are left with disabling headaches or epilepsy.
Ogden
J A
JA
Department of Psychology, University of Auckland, New Zealand.
Utley
T
T
Mee
E W
EW
D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000601:surgery*; D001925:Brain Damage, Chronic / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D009520:New Zealand; D011183:Postoperative Complications / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life; D012050:Rehabilitation, Vocational / Q000523:psychology; D012917:Social Adjustment; D013345:Subarachnoid Hemorrhage / Q000601:surgery*; D016896:Treatment Outcome