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Title: A cross-sectional study of executive functioning and quality of life after sub-arachnoid haemorrhage
Author: Harper, Alan M.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1997
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Despite many survivors of subarachnoid haemorrhage (S A H) being classed as having a 'good neurological outcome' (Glasgow Outcome Scale (GOS)=1) there is a growing awareness that these individuals may display a range of cognitive deficits (EG poor memory) and a reduced quality of life (EG impaired social relations). There appears to exist, therefore, a discrepancy between neurological and functional outcome. The site of the aneurysm appears to have little to do with these deficits, although the presence of delayed cerebral ischaemia may contribute to them. Rather, it is hypothesized that the SAH itself results in diffuse damage producing a sequelae reminiscent to that found after mild traumatic brain injury. The executive functions of the brain, due to the involvement of widespread locations and multiple cortical and sub-cortical circuits, are particularly sensitive to diffuse damage. As such, it is hypothesized that some patients despite being classed as having made a good recovery will show executive dysfunction. This is important, as it may in part explain the discrepancy between neurological and functional outcome, with poor executive functioning being predictive of cognitive impairment and reduced quality of life. In the present study a group of approximately 40 subjects, who were classified as G O S =1, were assessed with a range of measures examining executive functions, cognitive functions and psychosocial outcome including quality of life. The relationships between these variables were explored. The subjects were either early (6 to 12 months) or late (5+ years) post aneurysm which allowed the hypothesis that there would be no significant change in deficits over time to be tested. In addition, the influences of acute factors from the time of the aneurysm were examined. These results are discussed and the proposal made that SAH patients, even those making a seemingly good recovery, should be screened for cognitive and executive deficits using a brief assessment battery relatively soon post aneurysm. This would allow for the possible rehabilitation of any deficits, which may help ameliorate the poor psychosocial outcome found in some aneurysm patients.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available