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  • 1.
    von Vogelsang, Ann-Christin
    et al.
    Red Cross University College of Nursing. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Svensson, Mikael
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Wengström, Yvonne
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Forsberg, Christina
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Cognitive, Physical, and Psychological Status After Intracranial Aneurysm Rupture: A Cross-Sectional Study of a Stockholm Case Series 1996 to 19992013In: World Neurosurgery, ISSN 1878-8750, E-ISSN 1878-8769, Vol. 79, no 1, p. 130-135Article in journal (Refereed)
    Abstract [en]

    Objective

    We sought to (1) describe psychological, physical, and cognitive functions in patients 10 years after intracranial aneurysm rupture and (2) identify any differences in outcome variables between age groups, gender or aneurysm locations.

    Methods

    A consecutive sample of patients (n = 217) treated for intracranial aneurysm rupture at a neurosurgical clinic in Stockholm, Sweden, were followed-up in a cross-sectional design 10.1 years after the onset with questionnaires and telephone interviews. The outcome measures were psychological functions in terms of symptoms of anxiety or depression and physical and cognitive functions.

    Results

    Compared with the reference groups, the aneurysm patients scored greater levels of anxiety and depression than normal values. Patients with aneurysm rupture in the posterior circulation scored significantly more problems with anxiety and depression. Only 2.8% of the patients scored for severe physical disability. On a group level, cognition was lower than normal population levels; 21.7% of respondents scored below the cut-off value, indicating cognitive impairments.

    Conclusions

    Ten years after aneurysm rupture the majority of patients seem to be well-functioning physically, whereas the psychological and cognitive functions are affected. A screening of the mental health of these patients in connection to radiological follow-up might be helpful to identify which patients need further referral to psychiatric treatment for anxiety and depression disorders.

  • 2.
    von Vogelsang, Ann-Christin
    et al.
    Red Cross University College of Nursing. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Wengström, Yvonne
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Svensson, Mikael
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Forsberg, Christina
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Descriptive Epidemiology in Relation to Gender Differences and Treatment Modalities 10 Years After Intracranial Aneurysm Rupture in the Stockholm Cohort 1996–19992013In: World Neurosurgery, ISSN 1878-8750, E-ISSN 1878-8769, Vol. 80, no 3-4, p. 328-334Article in journal (Refereed)
    Abstract [en]

    Objective

    To describe epidemiology in relation to gender differences and treatment modalities 10 years after intracranial aneurysm rupture in the Stockholm cohort 1996–1999.

    Methods

    A total of 468 consecutive patients with aneurysmal subarachnoid hemorrhage were followed-up in a retrospective cohort design 10 years after rupture. Information on medical history, clinical variables, and treatments were obtained from patient records. Causes of death were obtained from patient records and The Swedish Cause of Death Register. Incidence of ruptured aneurysms per 100,000 people were calculated from male, female, and overall population data per year from 1996–1999.

    Results

    Ten years after aneurysm rupture 63.9% (n = 296) of patients were still alive. The overall 28-day case fatality was 19.4%; most often deaths were due to the initial hemorrhage. There were no significant differences in survival time between patients treated with clipping (8.4 years, 95% confidence interval 8.1–8.8), compared with endovascularly treated patients (8.2 years, 95% confidence interval 7.4–9.1) (log rank P = 0.550). The female incidence was higher than that of men, and women were significantly older at the onset of aneurysm rupture (55.7 vs. 52.8 years, P = 0.027).

    Conclusions

    Ten years after rupture, most treated patients were still alive. The mortality was highest in the first month after rupture, due to the initial hemorrhage. Gender differences were apparent in incidence, but 10 years after the rupture mortality rates and survival times were equal between men and women. Survival time was equal between patients within active treatment modalities.

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