title: Neuropsychiatric disturbance after aneurysmal subarachnoid hemorrhage.
abstract: Although aneurysmal subarachnoid hemorrhage (aSAH) accounts for only 3-5% of all strokes, a high degree of morbidity has been reported in this relatively young subset of patients. Neuropsychiatric disturbance has often been neglected in these reports. We aimed to investigate the pattern and pathological factors of chronic neuropsychiatric disturbance in aSAH patients. This cross-sectional observational four-center study was carried out in Hong Kong. Neuropsychiatric outcome (Neuropsychiatric Inventory Chinese Version [CNPI]) assessments were conducted cross-sectionally 1-4 years after ictus. Pathological factors considered were early brain injury as assessed by admission World Federation of Neurosurgical Societies grade, aneurysm treatment (clipping versus coiling), delayed cerebral infarction, and chronic hydrocephalus. One hundred and three aSAH patients' spouses or caregivers completed the CNPI. Forty-two (41%) patients were reported to have one or more domain(s) of neuropsychiatric disturbance. Common neuropsychiatric disturbance domains included agitation/aggression, depression, apathy/indifference, irritability/lability, and appetite/eating disturbance. Chronic neuropsychiatric disturbance was associated with presence of chronic hydrocephalus. A subscore consisting of the five commonly affected domains seems to be a suitable tool for aSAH patients and should be further validated and replicated in future studies.
authors.affiliation: Division of Neurosurgery, Department of Surgery, 4/F Clinical Science Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong Special Administrative Region. Electronic address: georgewong@surgery.cuhk.edu.hk.
authors.forename: George Kwok Chu
authors.initials: GK
authors.lastname: Wong
authors.affiliation: Division of Neurosurgery, Department of Surgery, 4/F Clinical Science Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong Special Administrative Region.
authors.forename: Sandy Wai
authors.initials: SW
authors.lastname: Lam
authors.affiliation: Department of Psychiatry, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
authors.forename: Sandra S M
authors.initials: SS
authors.lastname: Chan
authors.affiliation: Division of Neurosurgery, Department of Surgery, 4/F Clinical Science Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong Special Administrative Region.
authors.forename: Mary
authors.initials: M
authors.lastname: Lai
authors.affiliation: Division of Neurosurgery, Department of Surgery, 4/F Clinical Science Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong Special Administrative Region.
authors.forename: Patty P P
authors.initials: PP
authors.lastname: Tse
authors.affiliation: Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mok
authors.affiliation: Division of Neurosurgery, Department of Surgery, 4/F Clinical Science Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong Special Administrative Region.
authors.forename: Wai Sang
authors.initials: WS
authors.lastname: Poon
authors.affiliation: Department of Psychological Studies, The Hong Kong Institute of Education, Tai Po, New Territories, Hong Kong Special Administrative Region.
authors.forename: Adrian
authors.initials: A
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult
keywords: Cerebral aneurysm; Neuropsychiatric disturbance; Stroke; Subarachnoid hemorrhage