Long-term cognitive effects of comorbid epilepsy on survivors of aneurysmal subarachnoid hemorrhages.

INTRODUCTION

An aneurysmal subarachnoid hemorrhage (aSAH) is a severe type of hemorrhagic stroke associated with substantial morbidity and long-term cognitive sequelae even when functional recovery appears to be satisfactory. Epilepsy-a common complication in aSAH survivors-is associated with worse outcomes, including increased mortality and disability and a diminished quality of life. This cross-sectional study investigates the long-term cognitive, functional, and quality-of-life outcomes for aSAH patients who develop epilepsy, comparing them to controls without epilepsy.

METHODS

This study involved 20 patients with epilepsy and 18 control subjects, recruited using the Kuopio Intracranial Aneurysm Database. The participants were evaluated 12 years after their aSAH at Kuopio University Hospital. Cognitive abilities, fatigue levels, depressive symptoms, and quality of life were measured using neuropsychological assessments and validated self-report instruments.

RESULTS

The analysis revealed no statistically significant differences in cognitive performance between the two groups, encompassing areas such as working memory, verbal and visual memory, processing speed, executive function, and verbal skills. Similarly, the assessments of fatigue, depression, and quality of life revealed no disparities.

CONCLUSIONS

Our study suggests that the neuropsychological outcomes in this population are primarily sequelae of the aSAH itself rather than additive cognitive effects of epilepsy. An important strength of this study is the relatively long median follow-up time of 12 years, allowing the evaluation of long-term outcomes after aSAH. However, the study's limitations include a small sample size and a considerable number of patients being lost to follow-up. Future research with larger participant groups is needed to further clarify the intricate cognitive and psychological effects of epilepsy in survivors of aSAH and to develop targeted interventions intended to improve their long-term outcomes.