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Fortschr Neurol Psychiatr 2020; 88(01): 33-39
DOI: 10.1055/a-1003-6756
Übersicht

Neuropsychologische Langzeitfolgen und Teilhabestörungen nach aneurysmatischer Subarachnoidalblutung (aSAB)

Long-term neuropsychological and participation impairment after aneurysmal subarachnoid hemorrhage (aSAH)
Jens D. Rollnik
1   Institut für neurorehabilitative Forschung (InFo), Medizinische Hochschule Hannover, BDH-Klinik Hess. Oldendorf gGmbH
,
Anna Adner
2   Klinische Neuropsychologie, BDH-Klinik Hessisch Oldendorf gGmbH
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Zusammenfassung

Das vorliegende Review beschäftigt sich mit kognitiven Störungen und Teilhabebeeinträchtigungen nach aneurysmatischen Subarachnoidalblutungen (aSAB). Diese können auch ohne den Nachweis einer substanziellen Hirnschädigung in der neuropsychologisch zu erwartenden Region auftreten. Als Ursache für diese Diskrepanz gelten neuroinflammatorische Prozesse und oxidativer Stress. Am häufigsten sind das verbale Gedächtnis, visuell-räumliche Fähigkeiten, das Gedächtnis für visuelle Inhalte, Aufmerksamkeit, Arbeitsgedächtnis, Exekutivfunktionen (Planung, Kontrolle, Problemlösung, Aufmerksamkeit, Entscheidungsfindung), die allgemeine kognitive Verarbeitungsgeschwindigkeit und die sprachliche Domäne betroffen. Es zeigt sich, dass das Vorhandensein kognitiver Beeinträchtigungen einen wesentlichen Risikofaktor darstellt, nicht mehr beruflich reintegriert werden zu können. Zusätzlich zu den kognitiven Symptomen treten nach einer aSAB auch gehäuft psychiatrische Symptome wie Angst, Depression und Fatigue auf. Diese wirken sich zusätzlich zu den körperlichen und kognitiven Beeinträchtigungen negativ auf die Teilhabe am beruflichen und sozialen Leben aus, was wiederum zu einer schlechteren Lebensqualität beiträgt.

Abstract

The present review focuses on cognitive and participation impairments after aneurysmal subarachnoidal hemorrhage (aSAH). Such impairments may be present even in cases without evidence of damage in the neuropsychologically expected brain area. Neuroinflammation and oxidative stress may be responsible for this finding. Most frequently, cognitive impairment can be found in the verbal memory domain, visuospatial skills and memory domain, attention and working memory domain, executive functions (planning, central control, problem solving, attention, decision making), psychomotor speed and language domain. The presence of cognitive deficits is a major risk factor not to return to work again. Together with cognitive impairment, psychiatric symptoms like anxiety, depression and fatigue may be observed. Psychiatric disturbances result in impairments of social and vocational participation and – consecutively – worsening of quality of life.

Schlüsselwörter

Aneurysmatische Subarachnoidalblutung - Kognition - Depression - Lebensqualität

Key words

aneurysmal subarachnoidal hemorrhage - cognition - depression - quality of life


Publikationsverlauf

Eingereicht: 15. Februar 2019

Angenommen: 18. August 2019

Artikel online veröffentlicht:
27. Januar 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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