Symptoms and consequences of subarachnoid haemorrhage after 7 years

Abstract

Objectives: Short-term follow-up studies after a subarachnoid haemorrhage (SAH) have shown impaired cognition, fatigue, depression and anxiety, but less is known regarding long-term consequences. The aim of this study was to investigate health outcomes in persons 7 years after SAH. Materials and Methods: This is a descriptive cohort follow-up study of persons with non-traumatic SAH treated at Sahlgrenska University Hospital, Gothenburg, Sweden. The follow-up was conducted 7 years post-treatment and included home visits using forms and questionnaires about health outcomes; the Barthel Index (BI), modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Assessment (MoCA) and Multidimensional Fatigue Inventory (MFI). Results: Seven years post-SAH, 33 persons fulfilled the inclusion criteria, of whom 18 (55%) participated (median age 63 years). Cognitive impairment was present in 11 participants, assessed with the MoCA, where the item of delayed recall was most difficult. The majority (n = 16) were independent in activities of daily living (ADL), and few (n = 3) had physical symptoms according to the NIHSS. However, three participants were free from disability according to the mRS. Nearly, half of the participants had symptoms of anxiety (n = 8). Three had symptoms of depression and more than half experienced fatigue. Conclusion: The physical function and independency in ADL is high among long-term SAH survivors. Despite this, only a few were completely free from disability, and the main problems 7 years after SAH were cognitive impairment and anxiety.