Devenir à long terme des patients après une HSA anévrismale

Adequate instruments for measuring patient outcome after subarachnoid aneurysmal haemorrhage (SAH) are required to interpret results of clinical trials before making clinical recommendations. Graded measures are generally used, e.g. Glasgow Outcome Scale (GOS) and the modified Rankin Scale (mRS). However, these scales are inappropriate to measure cognitive dysfunction, particularly in patients with good outcome. We investigated the most frequent complains, the working status and the self-assessment of handicap (quality of life) in GOS-5 patients after their surgical treatment of a ruptured aneurysm. A questionnaire was sent to 126 patients one year following their discharge from hospital. The questionnaire assessed their motor activity, vitality and psychological troubles and handicap. Over 84 patients with GOS-5, 55 (65%) had persistent cognitive and psychological troubles including memory deficit, vitality and depressive troubles. Providing the use of combined scales to assess handicap and quality of life, these results suggest that SAH can result in a persistent alteration of cognitive function in patients, even in those classified as having a good outcome using the routine graded scales.