DOI: 10.1161/jaha.126.049224 ISSN: 2047-9980

Neuropsychological and Quality‐of‐Life Outcomes After Aneurysmal Subarachnoid Hemorrhage

Elena Sagues, Lidia Diaz, Alex Van Dam, Navami Shenoy, Jose Romero‐Soto, Supti Biswas, Connor Aamot, Andres Gudino, Gowri Peethambar, James C Torner, Kenneth W Manzel, Natalia Garcia‐Casares, Edgar A Samaniego
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Background

Survivors of aneurysmal subarachnoid hemorrhage often have long‐term neuropsychological disturbances. This study aims to characterize depressive symptoms, quality of life, and personality changes in a large cohort of survivors of aneurysmal subarachnoid hemorrhage.

Methods

This cross‐sectional study included patients with a history of aneurysmal subarachnoid hemorrhage from the Brain Aneurysm Foundation patient registry. Patients completed the Beck Depression Inventory‐II and the Stroke‐Specific Quality of Life scale, and family members completed the Iowa Scales of Personality Change. Multiple linear regression was used to identify symptoms associated with reduced work productivity. Wilcoxon and chi‐square tests were used to identify variables associated with severity of depressive symptoms and personality changes.

Results

A total of 318 patients were included, with 242 completing the Beck Depression Inventory‐II and Stroke‐Specific Quality of Life, and 112 family members completing the Iowa Scales of Personality Change. Moderate depressive symptoms were reported by 18% of patients, and severe symptoms were reported by 11%. Impairments in thinking, social roles, language, and energy were independently associated with reduced work productivity. Acquired personality disturbances were observed in 72% of patients for executive function, 44% for social behavior, 49% for hypomotivation, 50% for irascibility, and 72% for distress. Ruptured aneurysms in the anterior cerebral and anterior communicating artery were associated with a trend toward a higher prevalence of moderate to severe depressive symptoms and executive personality changes.

Conclusions

Depressive symptoms and personality changes are common after aneurysmal subarachnoid hemorrhage, affecting work productivity. Recognizing challenges in thinking, social interactions, language, and vulnerability to pressure may help guide targeted interventions by families, employers, and health care providers.

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