Vasospasm: a risk factor for neuropsychological impairments after SAH?
Richardson (1989) found a significantly unfavorable influence of severe angiographically proven postoperative vasospasm on memory performance in comparison to those patients with no or only slight vasospasm. In a retrospective study of 219 patients two to 14 years after SAH, Larsson et al. (1989) found no influence of angiographically proven vasospasm in the acute stage of the illness on later neuropsychological test performance in working memory (Larsson et al., 1989). On the other hand, Gade (1982) found that in amnesties angiographically proven vasospasm was present in the acute stage more frequently, while, in contrast, Teissier Du Cros and Lhermitte (1984) were not able to demonstrate such a connection. In the study of Stenhouse et al. (1991) the neuropsychological most impaired patients had most frequently been subject to severe angiographically proven vasospasm. This was for Stenhouse et al. (1991) the most important cause for the impairments of the patients even though a third of them also presented with hydrocephalus. Moreover, both secondary complications make it plausible that these patients must have sustained a particularly severe bleeding. Unfortunately, detailed data on the severity of the bleeding are not supplied by Stenhouse et al. (1991). In so far, the conclusion of the authors that vasospasm was the cause for the severe cognitive impairments of the patients cannot be maintained without restrictions.