Abstract 156: The volume of aneurysmal subarachnoid hemorrhage is negatively correlated with cognitive outcomes

• Published in: Stroke: vascular and interventional neurology 2024-11, Vol.4 (S1)
• Main Authors: E Sagues Sese, Shenoy, N, A Van Dam, Gudino, A, Dier, C, Cabarique, M, Samaniego, E
• Format: Article
• Language: English
• Subjects: Hemorrhage; Ischemia
• ISSN: 2694-5746; 2694-5746
• DOI: 10.1161/SVIN.04.suppl_1.156

IntroductionSurvivors of aneurysmal subarachnoid hemorrhage (aSAH) often face cognitive challenges that hinder their ability to return to work and social activities. The factors influencing cognitive outcomes after aSAH are not well characterized. This study aims to analyze the relationship of hemorrhage volume in long‐term cognitive function in a large cohort of aSAH survivors.MethodsPatients with aSAH admitted to our institution since 2015 were recruited. Clinical variables, including the occurrence of vasospasm or new ischemia during hospitalization, were collected. Total hemorrhage volume was measured using semi‐automated software that generates segmentations of intracranial blood based on Hounsfield units. Anterior fissure and intraparenchymal hemorrhage volumes were quantified using CT scans at admission in PACS, employing the Freehand ROI tool to delineate the hematoma on each affected slide. The same method was used to quantify the total volume of ischemia from MRI FLAIR sequences. Patients underwent the Montreal Cognitive Assessment (MoCA) 6 months to 9 years post‐aSAH. Data were adjusted for sex, age, race, and years of education. Univariate and multivariate analyses were performed to identify predictors of cognitive outcomes.ResultsA total of 165 aSAH survivors were enrolled in the study. MoCA scores were significantly lower (below the 25th percentile for adjusted data) in patients who developed new radiological ischemia during hospitalization (OR: 3.42, p=0.03). Larger total hemorrhage volume was an independent predictor of worse MoCA performance in multivariate analysis (β: 0.97, p=0.048, figure). However, anterior fissure hemorrhage, intraparenchymal hemorrhage, and total ischemic volume were not significantly correlated with MoCA performance.ConclusionThe development of new ischemia and larger aSAH volumes are associated with worse cognitive outcomes following aSAH.