ORIGINAL RESEARCH article
Front. Neurol.
Sec. Cognitive and Behavioral Neurology
TIME-COURSE OF NEUROPSYCHOLOGICAL FUNCTIONING IN ANEURYSMAL SUBARACHNOID HAEMORRHAGE AND ITS ASSOCIATION WITH VASOSPASM
Provisionally accepted
Giorgia Abete Fornara1*
Claudia Fanizzi1
Elena Scagliotti1
Giorgio Fiore1
Valeria Conte2
Fabrizio Ortolano2
Tommaso Zoerle2,3
Marco Locatelli1,3
Giulio Andrea Andrea Bertani1- 1Department of Neurosurgery, IRCCS Ca 'Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
- 2Department of Anesthesia and Critical Care-Neuroscience Intensive Care Unit, IRCCS Ca 'Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
- 3Department of Medical-Surgical Physiopathology and Transplantation, Universita degli Studi di Milano, Milan, Italy
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Background: Aneurysmal Subarachnoid Haemorrhages (aSAH) and related vasospasm often cause several neurological and cognitive impairments in survivors. The long-term impact of aSAH and vasospasm on cognition remains a topic of debate. This study aims at describing cognitive functioning focusing on the acute phases after bleeding and for 18 months, and to investigate the immediate and long-term effects of vasospasm. Methods: Seventy adult patients were prospectively recruited and tested at different time points: within 48/72 hours from bleeding (T1); between 7 and 10 days after bleeding (T2); five long-term follow-ups from 1 (T3) to 18 months (T7). An extensive neuropsychological evaluation was administered, including level of daily functional independence. Results: at T1 all tests show high percentages of impairments (ranging from 38% to 100%), in particular for visual and verbal long-term memory, constructional praxis, abstract reasoning and functional independence. Many tasks gradually improve since T2, except for executive functions and visual memory which show a slower recovery. A severe diffuse impact of vasospasm emerges at T2 but a linear gradual recovery already since T3 emerges for almost all the investigated functions. At the last follow-ups several tests show no significant differences between patients with and without vasospasm. Conclusions: despite a severe diffuse impact of bleeding and vasospasm in the acute stages, a low prevalence of cognitive and functional impairments at the chronic phase emerges. Our data may help clinicians to better understand the cognitive and autonomy trajectories of recover over time, and to tailor eventual rehabilitation programs.
Keywords: Aneurysmal subarachnoid haemorrhage, cognitive impairment, daily independence, follow-up, vasospasm
Received: 23 Sep 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Abete Fornara, Fanizzi, Scagliotti, Fiore, Conte, Ortolano, Zoerle, Locatelli and Bertani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Giorgia Abete Fornara
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