To evaluate characteristics of cognitive impairments according to the location of aneurysmal subarachnoid hemorrhage (SAH) using a computerized neuropsychological test (CNT).
A total of 211 patients were transferred to our rehabilitation department after becoming neurologically stable following aneurysmal SAH. Twenty four of the 211 patients met the inclusion criteria and participated in a screening test using the mini-mental state examination (MMSE). Twenty patients with a MMSE score <26 were followed prospectively with a CNT and Beck depression inventory (BDI). Eleven patients had anterior communicating artery (ACoA) aneurysms and the other 9 had middle cerebral, internal carotid or posterior communicating artery aneurysms.
There were no differences in age, education, Hunt and Hess grade, or Fisher grade between the patients with ACoA aneurysmal SAH compared to patients with other aneurysmal SAH. In patients with ACoA aneurysmal SAH, scores of BDI (p=0.020), verbal learning test were lower than those of other aneurysmal SAH patients. In contrast, patients with non-ACoA aneurysmal SAH took significantly more time in auditory (p=0.025) and visual continuous performance tests (p=0.028). The cognitive deficit following aneurysmal SAH could be characterized by its location using CNT.
Using CNT in aneurysmal SAH patients could be a useful tool for evaluating the characteristics of cognitive impairment and planning rehabilitation programs according to each characteristic.
Citations
Objective: This research aimed to define the usefulness of the computerized neuropsychological test (CNT) for evaluation of cognitive deficit in the patients with brain injury.
Method: Twenty five subjects with brain injury (16 males, 9 females) were enrolled. Their mean age was 39.2 years. All patient were assessed their cognitive function using CNT. The CNT consisted of digit span, verbal learning test, visual span test, visual learning test, auditory continuous performance test, auditory controlled continuous performance test, visual continuous performance test, visual controlled continuous performance test, word-color test, hypothesis formation test and trail making test. Scores of each subtest on CNT analysed according to the brain lesion and involved hemisphere of the patients.
Results: In patients with left hemisphere lesion, scores in digit span and verbal-learning test were lower than that of right side lesion (p＜0.05). In contrast, patients with right hemisphere lesion showed significantly lower scores in visual span and visual-learning test (p＜0.05). The patients with frontal lobe lesion marked lower scores in verbal-learning and word-color test than the patients without frontal lesion (p＜0.01). Whereas the patients with parietal lobe lesion showed significantly lower scores in visual learning test (p＜0.05) than the patients without parietal lesion.
Conclusion: The cognitive deficit following the brain lesion could be characterized using CNT. CNT is considered to be used as a useful tool in the patients with brain injury for the assessment of their cognitive function.
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