Early brain injury and cognitive impairment after aneurysmal subarachnoid haemorrhage

Abstract The first 72 h following aneurysm rupture play a key role in determining clinical and cognitive outcomes after subarachnoid haemorrhage (SAH). Yet, very little is known about the impact of so called “early brain injury” on patents with clinically good grade SAH (as defined as World Federati...

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Autores principales:	Matthew J. Rowland, Payashi Garry, Martyn Ezra, Rufus Corkill, Ian Baker, Peter Jezzard, Jon Westbrook, Gwenaëlle Douaud, Kyle T. S. Pattinson
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6c85b39ff6f34420a0acc33093394972
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spelling	oai:doaj.org-article:6c85b39ff6f34420a0acc330933949722021-12-05T12:16:27ZEarly brain injury and cognitive impairment after aneurysmal subarachnoid haemorrhage10.1038/s41598-021-02539-x2045-2322https://doaj.org/article/6c85b39ff6f34420a0acc330933949722021-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-02539-xhttps://doaj.org/toc/2045-2322Abstract The first 72 h following aneurysm rupture play a key role in determining clinical and cognitive outcomes after subarachnoid haemorrhage (SAH). Yet, very little is known about the impact of so called “early brain injury” on patents with clinically good grade SAH (as defined as World Federation of Neurosurgeons Grade 1 and 2). 27 patients with good grade SAH underwent MRI scanning were prospectively recruited at three time-points after SAH: within the first 72 h (acute phase), at 5–10 days and at 3 months. Patients underwent additional, comprehensive cognitive assessment 3 months post-SAH. 27 paired healthy controls were also recruited for comparison. In the first 72 h post-SAH, patients had significantly higher global and regional brain volume than controls. This change was accompanied by restricted water diffusion in patients. Persisting abnormalities in the volume of the posterior cerebellum at 3 months post-SAH were present to those patients with worse cognitive outcome. When using this residual abnormal brain area as a region of interest in the acute-phase scans, we could predict with an accuracy of 84% (sensitivity 82%, specificity 86%) which patients would develop cognitive impairment 3 months later, despite initially appearing clinically indistinguishable from those making full recovery. In an exploratory sample of good clinical grade SAH patients compared to healthy controls, we identified a region of the posterior cerebellum for which acute changes on MRI were associated with cognitive impairment. Whilst further investigation will be required to confirm causality, use of this finding as a risk stratification biomarker is promising.Matthew J. RowlandPayashi GarryMartyn EzraRufus CorkillIan BakerPeter JezzardJon WestbrookGwenaëlle DouaudKyle T. S. PattinsonNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Matthew J. Rowland Payashi Garry Martyn Ezra Rufus Corkill Ian Baker Peter Jezzard Jon Westbrook Gwenaëlle Douaud Kyle T. S. Pattinson Early brain injury and cognitive impairment after aneurysmal subarachnoid haemorrhage
description	Abstract The first 72 h following aneurysm rupture play a key role in determining clinical and cognitive outcomes after subarachnoid haemorrhage (SAH). Yet, very little is known about the impact of so called “early brain injury” on patents with clinically good grade SAH (as defined as World Federation of Neurosurgeons Grade 1 and 2). 27 patients with good grade SAH underwent MRI scanning were prospectively recruited at three time-points after SAH: within the first 72 h (acute phase), at 5–10 days and at 3 months. Patients underwent additional, comprehensive cognitive assessment 3 months post-SAH. 27 paired healthy controls were also recruited for comparison. In the first 72 h post-SAH, patients had significantly higher global and regional brain volume than controls. This change was accompanied by restricted water diffusion in patients. Persisting abnormalities in the volume of the posterior cerebellum at 3 months post-SAH were present to those patients with worse cognitive outcome. When using this residual abnormal brain area as a region of interest in the acute-phase scans, we could predict with an accuracy of 84% (sensitivity 82%, specificity 86%) which patients would develop cognitive impairment 3 months later, despite initially appearing clinically indistinguishable from those making full recovery. In an exploratory sample of good clinical grade SAH patients compared to healthy controls, we identified a region of the posterior cerebellum for which acute changes on MRI were associated with cognitive impairment. Whilst further investigation will be required to confirm causality, use of this finding as a risk stratification biomarker is promising.
format	article
author	Matthew J. Rowland Payashi Garry Martyn Ezra Rufus Corkill Ian Baker Peter Jezzard Jon Westbrook Gwenaëlle Douaud Kyle T. S. Pattinson
author_facet	Matthew J. Rowland Payashi Garry Martyn Ezra Rufus Corkill Ian Baker Peter Jezzard Jon Westbrook Gwenaëlle Douaud Kyle T. S. Pattinson
author_sort	Matthew J. Rowland
title	Early brain injury and cognitive impairment after aneurysmal subarachnoid haemorrhage
title_short	Early brain injury and cognitive impairment after aneurysmal subarachnoid haemorrhage
title_full	Early brain injury and cognitive impairment after aneurysmal subarachnoid haemorrhage
title_fullStr	Early brain injury and cognitive impairment after aneurysmal subarachnoid haemorrhage
title_full_unstemmed	Early brain injury and cognitive impairment after aneurysmal subarachnoid haemorrhage
title_sort	early brain injury and cognitive impairment after aneurysmal subarachnoid haemorrhage
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/6c85b39ff6f34420a0acc33093394972
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Early brain injury and cognitive impairment after aneurysmal subarachnoid haemorrhage

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