Aneurysmal Subarachnoid Hemorrhage and Cognitive Deficits

Objective: Discuss cognitive deficits caused by subarachnoid hemorrhage (SAH) after rupture of cerebral aneurisms, since about half of the patients have severe or at least striking declines in one or more functions of the cognitive domain. Methods: This paper presents a literature review on cognitive deficits secondary to aneurysmal SAH. There was no delimitation of periods of publications or the locality where it was applied. The bibliographic references were accessed through the database PubMed (http://www.ncbi.nlm.nih.gov/pubmed/). Results: There are three main etiologies for the development of cognitive worsening: the effect of the initial bleeding, the consequences of vasospasm and delayed ischemia and the secondary ones to the treatment. Aneurysms located in the anterior communicating artery and in the middle cerebral artery seem to be related to worse evaluations. As surgical treatment seems to contribute to cognitive worsening, at least when evaluated early. Conclusion: Defining theinvolved factors in this pathology is a great challenge, since the papers of literature use different tests (Glasgow outcome scale or neuropsychological assessments), evaluate the patients in several stages (before or after treatment, being early or late) and compare the SAH patients with different groups (population without pathology or patients with unruptured aneurysms).