Neuropsychological Sequelae of Subarachnoid Hemorrhage and its Treatment

"... Das Buch ist ... empfehlenswert fur alle Arzte und Vertreter anderer Disziplinen, die sich im Rahmen von medizinischer Versorgung, Rehabilitation oder Forschungstatigkeit mit SAB-Patienten befassen. Es liefert dem Leser fundierte Information und wertvolle Anregungen." Der Nervenarzt 6/2001

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.