title: Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations.
abstract: BACKGROUND
  In a high proportion of patients with favorable outcome after aneurysmal subarachnoid hemorrhage (aSAH), neuropsychological deficits, depression, anxiety, and fatigue are responsible for the inability to return to their regular premorbid life and pursue their professional careers. These problems often remain unrecognized, as no recommendations concerning a standardized comprehensive assessment have yet found entry into clinical routines.
  
  
  METHODS
  To establish a nationwide standard concerning a comprehensive assessment after aSAH, representatives of all neuropsychological and neurosurgical departments of those eight Swiss centers treating acute aSAH have agreed on a common protocol. In addition, a battery of questionnaires and neuropsychological tests was selected, optimally suited to the deficits found most prevalent in aSAH patients that was available in different languages and standardized.
  
  
  RESULTS
  We propose a baseline inpatient neuropsychological screening using the Montreal Cognitive Assessment (MoCA) between days 14 and 28 after aSAH. In an outpatient setting at 3 and 12 months after bleeding, we recommend a neuropsychological examination, testing all relevant domains including attention, speed of information processing, executive functions, verbal and visual learning/memory, language, visuo-perceptual abilities, and premorbid intelligence. In addition, a detailed assessment capturing anxiety, depression, fatigue, symptoms of frontal lobe affection, and quality of life should be performed.
  
  
  CONCLUSIONS
  This standardized neuropsychological assessment will lead to a more comprehensive assessment of the patient, facilitate the detection and subsequent treatment of previously unrecognized but relevant impairments, and help to determine the incidence, characteristics, modifiable risk factors, and the clinical course of these impairments after aSAH.
authors.affiliation: Division of Neuropaediatrics, Development, and Rehabilitation, Department of Paediatrics, Inselspital Bern, Bern, Switzerland.
authors.forename: Antoinette E
authors.initials: AE
authors.lastname: Zweifel-Zehnder
authors.forename: Martin N
authors.initials: MN
authors.lastname: Stienen
authors.forename: Christian
authors.initials: C
authors.lastname: Chicherio
authors.forename: Aline
authors.initials: A
authors.lastname: Studerus-Germann
authors.forename: Stefan
authors.initials: S
authors.lastname: Bläsi
authors.forename: Stefania
authors.initials: S
authors.lastname: Rossi
authors.forename: Klemens
authors.initials: K
authors.lastname: Gutbrod
authors.forename: Nicole
authors.initials: N
authors.lastname: Schmid
authors.forename: Valérie
authors.initials: V
authors.lastname: Beaud
authors.forename: Christian
authors.initials: C
authors.lastname: Mondadori
authors.forename: Peter
authors.initials: P
authors.lastname: Brugger
authors.forename: Leonardo
authors.initials: L
authors.lastname: Sacco
authors.forename: Rene
authors.initials: R
authors.lastname: Müri
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hildebrandt
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Fournier
authors.forename: Emanuela
authors.initials: E
authors.lastname: Keller
authors.forename: Luca
authors.initials: L
authors.lastname: Regli
authors.forename: Javier
authors.initials: J
authors.lastname: Fandino
authors.forename: Luigi
authors.initials: L
authors.lastname: Mariani
authors.forename: Andreas
authors.initials: A
authors.lastname: Raabe
authors.forename: Roy Thomas
authors.initials: RT
authors.lastname: Daniel
authors.forename: Michael
authors.initials: M
authors.lastname: Reinert
authors.forename: Thomas
authors.initials: T
authors.lastname: Robert
authors.forename: Bawarjan
authors.initials: B
authors.lastname: Schatlo
authors.forename: Philippe
authors.initials: P
authors.lastname: Bijlenga
authors.forename: Karl
authors.initials: K
authors.lastname: Schaller
authors.forename: Andreas U
authors.initials: AU
authors.lastname: Monsch
mesh_terms: D001288:Attention; D003071:Cognition; D056344:Executive Function; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D008568:Memory; D009483:Neuropsychological Tests / Q000592:standards*; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D063189:Symptom Assessment / Q000592:standards