title: Non-aneurysmal non-perimesencephalic subarachnoid hemorrhage: effect of rehabilitation at short-term and in a prospective study of long-term follow-up.
abstract: A recently published prospective study identified an impaired outcome of patients with non-perimesencephalic (NPM) subarachnoid hemorrhage (SAH). Our objective was to analyze the long-term outcome of patients with subsequent rehabilitation after NPM SAH.
  
  
  
  A comparison of patients with NPM SAH receiving subsequent in-patient rehabilitation was done at discharge (using the modified Rankin scale (mRS)), short-term outcome after 6 months (mRS), and prospectively using a questionnaire (short-form health survey with 36 questions (SF-36)), which was sent to 66 patients.
  
  
  
  Thirty-seven patients answered the SF-36, on average 6.3 years after ictus (range 1.5-14 years). After NPM SAH, the mRS is impaired. Patients with subsequent rehabilitation had a significant better improvement until short-term follow-up. Until long-term outcome, the psychological items were non-significantly reduced, whereas all physical items (physical functioning, role limitations because of physical health problems, bodily pain, and general health perceptions) were significantly decreased compared to the standard population. In patients with subsequent rehabilitation, all items were only non-significantly reduced. About 16% of the patients developed secondary neurological and/or psychiatric diseases.
  
  
  
  The quality of life (QoL) is decreased after NPM SAH. In the long-term follow-up, a significant reduction in physical items was identified. Due to subsequent in-patient rehabilitation after NPM SAH, the impairment can be improved significantly until short-term follow-up. Whereas patients with NPM SAH had a significantly decreased QoL at long-term follow-up, for patients with rehabilitation, the QoL was only slightly (non-significantly) reduced. Therefore, patients should receive subsequent rehabilitation after NPM SAH to improve the functional short-term outcome (mRS) and long-term QoL. www.clinicaltrials.gov (Identifier No. NCT02334657).
authors.affiliation: a Department of Neurosurgery , Goethe-University Hospital , Frankfurt am Main , Germany.
authors.forename: Juergen
authors.initials: J
authors.lastname: Konczalla
authors.affiliation: a Department of Neurosurgery , Goethe-University Hospital , Frankfurt am Main , Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Schmitz
authors.affiliation: a Department of Neurosurgery , Goethe-University Hospital , Frankfurt am Main , Germany.
authors.forename: Sepide
authors.initials: S
authors.lastname: Kashefiolasl
authors.affiliation: a Department of Neurosurgery , Goethe-University Hospital , Frankfurt am Main , Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Senft
authors.affiliation: a Department of Neurosurgery , Goethe-University Hospital , Frankfurt am Main , Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Platz
authors.affiliation: a Department of Neurosurgery , Goethe-University Hospital , Frankfurt am Main , Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Seifert
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000066530:Neurological Rehabilitation / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000628:therapy*; D013997:Time Factors
keywords: Non-perimesencephalic; Quality of life; Rehabilitation outcome; SAH; Spontaneous; Subarachnoid hemorrhage