Long-term neuropsychological and participation impairment after aneurysmal subarachnoid hemorrhage (aSAH)

The present review focuses on cognitive and participation impairments after aneurysmal subarachnoidal hemorrhage (aSAH). Such impairments may be present even in cases without evidence of damage in the neuropsychologically expected brain area. Neuroinflammation and oxidative stress may be responsible for this finding. Most frequently, cognitive impairment can be found in the verbal memory domain, visuospatial skills and memory domain, attention and working memory domain, executive functions (planning, central control, problem solving, attention, decision making), psychomotor speed and language domain. The presence of cognitive deficits is a major risk factor not to return to work again. Together with cognitive impairment, psychiatric symptoms like anxiety, depression and fatigue may be observed. Psychiatric disturbances result in impairments of social and vocational participation and - consecutively worsening of quality of life.