Early brain injury and cognitive impairment after aneurysmal subarachnoid haemorrhage
| Autor: | Kyle T.S. Pattinson, Martyn Ezra, Gwenaëlle Douaud, Jon Westbrook, Ian Baker, Peter Jezzard, Payashi Garry, Rufus Corkill, Matthew J. Rowland |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Cerebellum Science Aneurysm Ruptured Article Aneurysm rupture Prognostic markers Internal medicine Humans Medicine Cognitive Dysfunction Prospective Studies cardiovascular diseases Cognitive impairment Aged Multidisciplinary business.industry Diagnostic markers Cognition Middle Aged Subarachnoid Hemorrhage Magnetic Resonance Imaging nervous system diseases Stroke medicine.anatomical_structure Brain Injuries Case-Control Studies Brain size Cardiology Biomarker (medicine) Female Subarachnoid haemorrhage Cognitive Assessment System business |
| Zdroj: | Scientific Reports Scientific Reports, Vol 11, Iss 1, Pp 1-11 (2021) |
| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-021-02539-x |
| Popis: | The first 72 h following aneurysm rupture play a key role in determining clinical and cognitive outcomes after subarachnoid haemorrhage (SAH). Yet, very little is known about the impact of so called “early brain injury” on patents with clinically good grade SAH (as defined as World Federation of Neurosurgeons Grade 1 and 2). 27 patients with good grade SAH underwent MRI scanning were prospectively recruited at three time-points after SAH: within the first 72 h (acute phase), at 5–10 days and at 3 months. Patients underwent additional, comprehensive cognitive assessment 3 months post-SAH. 27 paired healthy controls were also recruited for comparison. In the first 72 h post-SAH, patients had significantly higher global and regional brain volume than controls. This change was accompanied by restricted water diffusion in patients. Persisting abnormalities in the volume of the posterior cerebellum at 3 months post-SAH were present to those patients with worse cognitive outcome. When using this residual abnormal brain area as a region of interest in the acute-phase scans, we could predict with an accuracy of 84% (sensitivity 82%, specificity 86%) which patients would develop cognitive impairment 3 months later, despite initially appearing clinically indistinguishable from those making full recovery. In an exploratory sample of good clinical grade SAH patients compared to healthy controls, we identified a region of the posterior cerebellum for which acute changes on MRI were associated with cognitive impairment. Whilst further investigation will be required to confirm causality, use of this finding as a risk stratification biomarker is promising. |
| Databáze: | OpenAIRE |
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