Neuropsychological Sequelae of Subarachnoid Hemorrhage and its Treatment
Erschienen am 28. Juni 2011
XVI, 178 Seiten
978-3-7091-6327-6 (ISBN)
Beschreibung
The data about different aneurysm locations given in the present work clearly demonstrate that the quality and the severity of the neuropsycho logical impairments after subarachnoid hemorrhage are in particular dependent on the anatomical location and extent of the bleeding. In addition, the sometimes inevitable temporary clipping of perforating vessels seems to play a significant role with respect to later neuropsychological disturbances. Since modern aneurysm surgery is performed in the acute phase shortly after the hemorrhage, the findings reported in the present work are, according to my opinion, of particular relevance. In the light of the present intensive discussion about the indication for microneurosurgical clipping or neuroradiological interventional coiling of intracranial aneurysms, the results given here in by B. O. Hutter can be regarded as an argument for the surgical intervention, in particular because the extravasated blood can only be cleared by surgery. Therefore, this book may be an inspiration for the neurosurgical reader for a closer collaboration with psychologically trained scientists. This is important for all intracranial processes and not only for the topic of subarachnoid hemorrhage covered by this book.
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Inhalt
1. Introduction.- 2. Clinical appearance, pathology and diagnostics of subarachnoid hemorrhage (SAH).- 2.1. Definition, epidemiology and etiology.- 2.2. Epidemiology of SAH as a result of the rupture of an aneurysm and of spontaneous SAH without a proven source of the bleeding.- 2.3. Pathophysiology of SAH.- 2.4. Clinical features of acute SAH.- 2.5. Diagnostics of acute SAH.- 2.6. The most common classification systems to assess the state of a patient and the severity of SAH.- 2.7. Natural course of SAH.- 3. Therapy of SAH.- 3.1. General principles.- 3.2. Operative therapy of ruptured intracranial aneurysms.- 3.3. Postoperative mortality after aneurysm rupture.- 4. Special aspects of the pathology and therapy of SAH.- 4.1. The importance of the anatomical distribution of the hemorrhage.- 4.2. Intraventricular hemorrhage.- 4.3. Intracerebral hemorrhage.- 5. Cerebral vasospasm after SAH.- 6. Early surgery of patients grade IV or V after Hunt and Hess.- 7. Neuropsychological sequelae of SAH.- 7.1. Early studies on the neuropsychological sequelae of SAH.- 7.2. The discrepancy between a good neurological state and the neuropsychological impairments in patients after SAH.- 8. Basics of scientific research on the neuropsychological sequelae of subarachnoid hemorrhage.- 8.1. General methodological considerations.- 8.2. Strengths and weakness of neuropsychological measures in patients after SAH.- 8.3. The measurement of health-related quality of life of patients after SAH by means of the Aachen Life Quality Inventory (ALQI).- 8.4. Disturbances of affectivity and personality in patients after brain damage.- 8.5. The assessment of psychological adjustment after SAH by means of the revised Freiburger Personality Inventory (FPI-R).- 9. The pattern of cognitive deficits in the chronic state after subarachnoid hemorrhage.- 9.1. Impact on general intelligence.- 9.2. Cognitive deficits after SAH.- 10. Neuropsychological effects of aneurysm location.- 10.1. Are there specific neurobehavioral sequelae depending on the localization of the ruptured aneurysm?.- 10.2. Disconnection syndromes after aneurysm rupture.- 10.3. Cognitive deficits after rupture and surgical treatment of an aneurysm of the ACoA.- 11. Impairments in daily life after SAH.- 12. Psychological adjustment and depression after SAH.- 13. Ability to work and professional performance capacity in patients after SAH.- 14. Neurobehavioral sequelae of SAH without a proven source of the bleeding in comparison to the sequelae of the rupture of an intracranial aneurysm.- 14.1. Comparison of the cognitive deficits in both patient groups.- 14.2. Comparison of the impairments in quality of life between operated patients and those with SAH without a proven source of the bleeding...- 15. Neuropsychological sequelae of aneurysm surgery.- 16. Neurobehavioral sequelae of the anatomical bleeding pattern.- 17. Short- and long-term effects of disturbed CSF circulation after SAH.- 18. Health-related quality of life in patients who had been in Hunt and Hess grades IV or V on admission to the neurosurgical unit.- 19. Vasospasm: a risk factor for neuropsychological impairments after SAH?.- 20. Prognostic factors of the neurobehavioral late result after SAH.- 21. SAH as a psychological trauma.- 22. Problems of rehabilitation of patients after SAH.- 22.1. Spontaneous functional regeneration after SAH.- 22.2. General elements of rehabilitation after SAH.- 22.3. Scientific studies on the effectiveness of neuropsychological rehabilitation measures in patients after SAH.- 23. Closing discussion and outlook.- 24. References.
