title: Cerebral vasospasm and health-related quality of life after subarachnoid hemorrhage.
abstract: OBJECTIVE
  To examine the influence of cerebral vasospasm on health-related quality of life after subarachnoid hemorrhage. An additional objective was to determine how the timing of nimodipine therapy can influence health-related quality of life.
  
  
  METHODS
  Patients treated between 1998 and 2008 for nontraumatic subarachnoid hemorrhages were sent a standardized questionnaire for the purposes of documenting their health-related quality of life. Initially the patients were divided into two groups: those with and those without cerebral vasospasm after hemorrhage (radiologically confirmed). They were then differentiated according to four types of treatment options for vasospasm: 1) nimodipine since admission (N = 179); 2) nimodipine since diagnosis of vasospasm (N = 14); 3) no nimodipine/no vasospasm (N = 34); and 4) no nimodipine despite vasospasm (N = 5). Significance was established as P ≤ 0.05.
  
  
  RESULTS
  Evaluable questionnaires were returned by 236 patients (68% women, mean age 56.35 ± 12.68 years; 32% men, mean age 54.57 ± 12.20 years). Health-related quality of life generally appeared to be impaired. Yet with the exception of the subscale (1 of 8) of physical role (P = 0.019), there were no differences between patients with and without vasospasm. Variations in the different treatment options revealed significant effects in terms of the component summaries and subscales: physical role and pain, general health, vitality, social functioning, emotional role, mental health, and mental component summary (P ≤ 0.04).
  
  
  CONCLUSIONS
  Cerebral vasospasm had little influence on health-related quality of life in our patient population. Health-related quality of life cannot be used as the only argument in favor of treating cerebral vasospasm with nimodipine.
authors.affiliation: Universitätsklinikum Ulm, Neurochirurgische Klinik, Ulm, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Tjahjadi
authors.forename: Ralph
authors.initials: R
authors.lastname: König
authors.forename: Christian Rainer
authors.initials: CR
authors.lastname: Wirtz
authors.forename: Dieter
authors.initials: D
authors.lastname: Woischneck
authors.forename: Thomas
authors.initials: T
authors.lastname: Kapapa
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D004644:Emotions / Q000502:physiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009553:Nimodipine / Q000627:therapeutic use; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D011788:Quality of Life; D012189:Retrospective Studies; D018434:Sickness Impact Profile; D012919:Social Behavior; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000523:psychology* / Q000601:surgery; D014665:Vasodilator Agents / Q000627:therapeutic use; D020301:Vasospasm, Intracranial / Q000188:drug therapy / Q000209:etiology* / Q000523:psychology*; D055815:Young Adult
chemical_list: D014665:Vasodilator Agents; D009553:Nimodipine