Recovery after subarachnoid haemorrhage

Abstract

Objective - To determine the implications of subarachnoid haemorrhage for quality of life and aftercare. Design - Prospective follow up study of patients surviving subarachnoid haemorrhage over one year (at discharge, three months, and one year) by examination of cognitive functions (a test battery) and changes in everyday life (semistructured interview). Setting - Regional neurosurgical unit at a tertiary referral centre. Patients - 100 patients with subarachnoid haemorrhage; 17 were lost during the study because of ineligibility (further surgery, previous head injury, relevant psychiatric history, and cultural differences), loss of contact, and non-compliance; a further 13 patients who developed a neurological deficit were considered separately. Main outcome measure - Performance on cognitive test battery and reported changes in quality of life. Results - At discharge patients with and without neurological deficit scored below established norms with most tests, but by three months the difference had resolved in patients with deficit. Reduced quality of life attributable to subarachnoid haemorrhage at one year mainly included less energy (seven patients), adverse emotional changes (five), early retirement, affected social life, and domestic tension (three each). None reported reduced capacity for work. Conclusions - Patients surviving subarachnoid haemorrhage without neurological symptoms have a good prognosis and should be encouraged to return to a normal lifestyle within about three months.