Executive deficits and prediction of outcome in patients with angiographically negative SAH or neurosurgically treated aneurysmal SAH

Objective: Executive functions are crucial for adapting behavior to complex situations and are therefore likely to determine impaired daily functioning after subarachnoid hemorrhage (SAH). This study aims to investigate the presence of executive deficits and its predictive value on long-term return to work (RTW) after SAH. To assess the possible influence of neurosurgical treatment, differences between angiographically negative SAH (anSAH) and neurosurgically treated aneurysmal SAH (aSAH) are examined. Participants and methods: 22 anSAH patients (mean age 53.4) and 59 aSAH patients (mean age 53) were investigated. Executive functions were examined using the Zoo Map, Trail Making Test (TMT), Letter Fluency, and Dysexecutive Questionnaire (DEX, including proxy version). The Role Resumption List (RRL) was used to assess RTW. Between-group comparisons were made using Mann-Whitney and independent t-tests. Results: 45.5% of anSAH patients and 66.1% of aSAH patients reported incomplete RTW. Impaired performances on the Zoo Map, TMT and Fluency were found in respectively 54.5%, 4.5%, and 10.5% of anSAH patients and 62.7%, 15.8%, and 18.6% of aSAH patients. No significant differences in cognitive impairments were found between aSAH and anSAH patients. Considering the anSAH patient group, higher DEX and DEX Proxy scores were found in patients with incomplete RTW (p<0.05). Conclusions: Work resumption is seriously affected after aSAH and anSAH. Furthermore, executive deficits are present in this group, with more executive complaints in anSAH patients who report incomplete RTW. A more detailed analysis of these preliminary results will be performed to describe the predictive value of executive deficits on RTW.