{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T18:37:43Z","timestamp":1780079863830,"version":"3.54.0"},"reference-count":62,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Authors of this study aimed to characterize the neuropsychological profile of survivors of aneurysmal subarachnoid hemorrhage (aSAH) and identify clinical variables associated with poor cognitive outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This retrospective observational study included patients with an aSAH diagnosis from 2009 to 2024. Cognitive outcomes were assessed at least 6 months after aSAH using the 22-item Montreal Cognitive Assessment (MoCA-22), Digit Span Test Forward (DST-F), Digit Span Test Backward (DST-B), and Verbal Fluency Test (VFT). Poor cognitive outcomes were defined as an MoCA-22 score &lt; 25th percentile for population norms. Multivariable logistic regression was used to identify factors associated with poor cognitive outcomes. A subset of patients also completed the Beck Depression Inventory II, Stroke-Specific Quality of Life Scale, and Iowa Scales of Personality Change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 156 patients were included. Fifty-three patients (34%) had an MoCA-22 score &lt; 25th percentile, even though 79% of them had a modified Rankin Scale score \u2264 2 at discharge. Moderate and severe deficits (z-score &lt; 1 SD) were observed in 11% of patients (17\/156) on the DST-F, 27% (42\/156) on the DST-B, and 9% (14\/156) on the VFT. A modified Fisher grade 4 on admission (36\/53, 68% vs 45\/103, 44%) and infarction during hospitalization (16\/53, 30% vs 11\/103, 11%) were significantly associated with poor cognitive outcomes (adjusted odds ratio [aOR] 2.43, IQR 1.17\u20135.16, p = 0.018; and aOR 2.71, IQR 1.10\u20136.79, p = 0.029, respectively). Infarction also negatively impacted work productivity (OR 0.69, p = 0.015) and social relationships (OR 0.72, p = 0.029). Additionally, 27% of patients (12\/44) reported at least mild depressive symptoms and 64% (29\/45) acquired a personality disturbance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Survivors of aSAH can experience neuropsychological deficits, particularly those affecting executive function and working memory, despite good functional recovery. In this study, a modified Fisher grade 4 and new radiological infarction during hospitalization were associated with poor cognitive outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.7.jns251280","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T01:41:59Z","timestamp":1769218919000},"page":"517-525","source":"Crossref","is-referenced-by-count":1,"title":["Neuropsychological profile and risk factors for poor cognitive outcomes in survivors of aneurysmal subarachnoid hemorrhage"],"prefix":"10.3171","volume":"144","author":[{"given":"Elena","family":"Sagues","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Iowa, Iowa City;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Van Dam","sequence":"additional","affiliation":[{"name":"Carver College of Medicine, University of Iowa, Iowa City, Iowa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navami","family":"Shenoy","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa, Iowa City;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Ojeda","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Connecticut, Hartford, Connecticut;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Molina","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa, Iowa City;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Dier","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa, Iowa City;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Gudino","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa, Iowa City;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen E.","family":"Dlouhy","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Zanaty","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Ortega-Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa, Iowa City;"},{"name":"Departments of Neurosurgery,"},{"name":"Radiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linder","family":"Wendt","sequence":"additional","affiliation":[{"name":"Epidemiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Torner","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa, Iowa City;"},{"name":"Departments of Neurosurgery,"},{"name":"Epidemiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth W.","family":"Manzel","sequence":"additional","affiliation":[{"name":"Psychology, University of Iowa, Iowa City, Iowa; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel T.","family":"Tranel","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa, Iowa City;"},{"name":"Carver College of Medicine, University of Iowa, Iowa City, Iowa;"},{"name":"Psychology, University of Iowa, Iowa City, Iowa; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Garc\u00eda-Casares","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad de M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar A.","family":"Samaniego","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa, Iowa City;"},{"name":"Departments of Neurosurgery,"},{"name":"Radiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Neurology","first-page":"1413","article-title":"The burden, trends, and demographics of mortality from subarachnoid hemorrhage","volume":"50","author":"Johnston SC","year":"1998","unstructured":"Johnston SC, Selvin S, Gress DR. The burden, trends, and demographics of mortality from subarachnoid hemorrhage. Neurology. 1998;50(5):1413\u20131418."},{"issue":"9","key":"b2","series-title":"J Stroke Cerebrovasc Dis","first-page":"105027","article-title":"Severe cognitive impairment in aneurysmal subarachnoid hemorrhage: predictors and relationship to functional outcome","volume":"29","author":"Geraghty JR","year":"2020","unstructured":"Geraghty JR, Lara-Angulo MN, Spegar M, Reeh J, Testai FD. Severe cognitive impairment in aneurysmal subarachnoid hemorrhage: predictors and relationship to functional outcome. J Stroke Cerebrovasc Dis. 2020;29(9):105027."},{"issue":"10355","key":"b3","series-title":"Lancet","first-page":"846","article-title":"Spontaneous subarachnoid haemorrhage","volume":"400","author":"Claassen J","year":"2022","unstructured":"Claassen J, Park S. Spontaneous subarachnoid haemorrhage. Lancet. 2022;400(10355):846\u2013862."},{"issue":"5","key":"b4","series-title":"Qual Life Res","first-page":"1027","article-title":"Determinants of health-related quality of life after aneurysmal subarachnoid hemorrhage: a systematic review","volume":"22","author":"Passier PE","year":"2013","unstructured":"Passier PE, Visser-Meily JM, Rinkel GJ, Lindeman E, Post MW. Determinants of health-related quality of life after aneurysmal subarachnoid hemorrhage: a systematic review. Qual Life Res. 2013;22(5):1027\u20131043."},{"issue":"1","key":"b5","series-title":"Neurocrit Care","first-page":"70","article-title":"Cognitive, mental health, functional, and quality of life outcomes 1 year after spontaneous subarachnoid hemorrhage: a prospective observational study","volume":"41","author":"Rass V","year":"2024","unstructured":"Rass V, Altmann K, Zamarian L,  Cognitive, mental health, functional, and quality of life outcomes 1 year after spontaneous subarachnoid hemorrhage: a prospective observational study. Neurocrit Care. 2024;41(1):70\u201379."},{"issue":"3","key":"b6","series-title":"Neurosurgery","first-page":"475","article-title":"Cognitive functioning and health-related quality of life 1 year after aneurysmal subarachnoid hemorrhage in preoperative comatose patients (Hunt and Hess Grade V patients)","volume":"66","author":"Haug T","year":"2010","unstructured":"Haug T, Sorteberg A, Finset A, Lindegaard KF, Lundar T, Sorteberg W. Cognitive functioning and health-related quality of life 1 year after aneurysmal subarachnoid hemorrhage in preoperative comatose patients (Hunt and Hess Grade V patients). Neurosurgery. 2010;66(3):475\u2013485."},{"key":"b7","series-title":"World Neurosurg","first-page":"e527","article-title":"Risk factors for mild cognitive impairment in patients with aneurysmal subarachnoid hemorrhage treated with endovascular coiling","volume":"119","author":"Shen Y","year":"2018","unstructured":"Shen Y, Dong Z, Pan P, Shi H, Song Y. Risk factors for mild cognitive impairment in patients with aneurysmal subarachnoid hemorrhage treated with endovascular coiling. World Neurosurg. 2018;119:e527\u2013e533."},{"issue":"2","key":"b8","series-title":"Acta Neurochir (Wien)","first-page":"233","article-title":"Predicting return to work after subarachnoid hemorrhage using the Montreal Cognitive Assessment (MoCA)","volume":"158","author":"Wallmark S","year":"2016","unstructured":"Wallmark S, Ronne-Engstr\u00f6m E, Lundstr\u00f6m E. Predicting return to work after subarachnoid hemorrhage using the Montreal Cognitive Assessment (MoCA). Acta Neurochir (Wien). 2016;158(2):233\u2013239."},{"issue":"6","key":"b9","series-title":"Arch Clin Neuropsychol","first-page":"747","article-title":"The Montreal Cognitive Assessment: norms and reliable change indices for standard and MoCA-22 administrations","volume":"39","author":"Ratcliffe LN","year":"2024","unstructured":"Ratcliffe LN, Hale AC, McDonald T,  The Montreal Cognitive Assessment: norms and reliable change indices for standard and MoCA-22 administrations. Arch Clin Neuropsychol. 2024;39(6):747\u2013765."},{"issue":"1","key":"b10","series-title":"Alzheimers Dement (Amst)","first-page":"e12144","article-title":"T-MoCA: a valid phone screen for cognitive impairment in diverse community samples","volume":"13","author":"Katz MJ","year":"2021","unstructured":"Katz MJ, Wang C, Nester CO,  T-MoCA: a valid phone screen for cognitive impairment in diverse community samples. Alzheimers Dement (Amst). 2021;13(1):e12144."},{"issue":"11","key":"b11","series-title":"Article in Spanish. Rev Neurol","first-page":"317","article-title":"Usefulness of the Beck depression inventory in the diagnosis of depressive disorders in multiple sclerosis","volume":"78","author":"Aparicio-Castro E","year":"2024","unstructured":"Aparicio-Castro E, Candeliere-Merlicco A, Mar\u00eda Santa C, Villaverde-Gonz\u00e1lez R. Usefulness of the Beck depression inventory in the diagnosis of depressive disorders in multiple sclerosis. Article in Spanish. Rev Neurol. 2024;78(11):317\u2013322."},{"issue":"7","key":"b12","series-title":"Stroke","first-page":"1362","article-title":"Development of a stroke-specific quality of life scale","volume":"30","author":"Williams LS","year":"1999","unstructured":"Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a stroke-specific quality of life scale. Stroke. 1999;30(7):1362\u20131369."},{"issue":"8","key":"b13","series-title":"J Clin Exp Neuropsychol","first-page":"833","article-title":"Dimensions of personality disturbance after focal brain damage: investigation with the Iowa Scales of Personality Change","volume":"33","author":"Barrash J","year":"2011","unstructured":"Barrash J, Asp E, Markon K, Manzel K, Anderson SW, Tranel D. Dimensions of personality disturbance after focal brain damage: investigation with the Iowa Scales of Personality Change. 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Arch Clin Neuropsychol. 1999;14(2):167\u2013177."},{"issue":"2","key":"b20","series-title":"Neurol Sci","first-page":"529","article-title":"Teleneuropsychology: normative data for the assessment of memory in online settings","volume":"44","author":"Rizzi E","year":"2023","unstructured":"Rizzi E, Vezzoli M, Pegoraro S, Facchin A, Strina V, Daini R. Teleneuropsychology: normative data for the assessment of memory in online settings. Neurol Sci. 2023;44(2):529\u2013538."},{"issue":"3","key":"b21","series-title":"Exp Aging Res","first-page":"201","article-title":"Role of age, education, and gender on cognitive performance in the Framingham Heart Study: community-based norms","volume":"23","author":"Elias MF","year":"1997","unstructured":"Elias MF, Elias PK, D\u2019Agostino RB, Silbershatz H, Wolf PA. Role of age, education, and gender on cognitive performance in the Framingham Heart Study: community-based norms. 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J Am Heart Assoc. 2021;10(15):e021845."},{"issue":"11","key":"b24","series-title":"Stroke","first-page":"3099","article-title":"Location, infarct load, and 3-month outcomes of delayed cerebral infarction after aneurysmal subarachnoid hemorrhage","volume":"46","author":"Wong GKC","year":"2015","unstructured":"Wong GKC, Nung RCH, Sitt JCM,  Location, infarct load, and 3-month outcomes of delayed cerebral infarction after aneurysmal subarachnoid hemorrhage. Stroke. 2015;46(11):3099\u20133104."},{"issue":"1","key":"b25","series-title":"Acta Neurochir (Wien)","first-page":"177","article-title":"Predictors of cognitive function in the acute phase after aneurysmal subarachnoid hemorrhage","volume":"161","author":"Haug Nordenmark T","year":"2019","unstructured":"Haug Nordenmark T, Karic T, Sorteberg W, Sorteberg A. Predictors of cognitive function in the acute phase after aneurysmal subarachnoid hemorrhage. 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Personality changes after subarachnoid hemorrhage: a systematic review and meta-analysis. J Psychosom Res. 2022;156:110762."},{"issue":"537","key":"b30","series-title":"Br J Psychiatry","first-page":"129","article-title":"Brain damage and personality change after subarachnoid haemorrhage","volume":"117","author":"Storey PB","year":"1970","unstructured":"Storey PB. Brain damage and personality change after subarachnoid haemorrhage. Br J Psychiatry. 1970;117(537):129\u2013142."},{"issue":"1","key":"b31","series-title":"Neurosurgery","first-page":"91","article-title":"Subarachnoid hemorrhage treated with clipping: long-term effects on employment, relationships, personality, and mood","volume":"60","author":"Wermer MJ","year":"2007","unstructured":"Wermer MJ, Kool H, Albrecht KW, Rinkel GJ. Subarachnoid hemorrhage treated with clipping: long-term effects on employment, relationships, personality, and mood. 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J Stroke Cerebrovasc Dis. 2020;29(9):105027."},{"issue":"10355","key":"b3","series-title":"Lancet","first-page":"846","article-title":"Spontaneous subarachnoid haemorrhage","volume":"400","author":"Claassen J","year":"2022","unstructured":"Claassen J, Park S. Spontaneous subarachnoid haemorrhage. Lancet. 2022;400(10355):846\u2013862."},{"issue":"5","key":"b4","series-title":"Qual Life Res","first-page":"1027","article-title":"Determinants of health-related quality of life after aneurysmal subarachnoid hemorrhage: a systematic review","volume":"22","author":"Passier PE","year":"2013","unstructured":"Passier PE, Visser-Meily JM, Rinkel GJ, Lindeman E, Post MW. Determinants of health-related quality of life after aneurysmal subarachnoid hemorrhage: a systematic review. Qual Life Res. 2013;22(5):1027\u20131043."},{"issue":"1","key":"b5","series-title":"Neurocrit Care","first-page":"70","article-title":"Cognitive, mental health, functional, and quality of life outcomes 1 year after spontaneous subarachnoid hemorrhage: a prospective observational study","volume":"41","author":"Rass V","year":"2024","unstructured":"Rass V, Altmann K, Zamarian L,  Cognitive, mental health, functional, and quality of life outcomes 1 year after spontaneous subarachnoid hemorrhage: a prospective observational study. Neurocrit Care. 2024;41(1):70\u201379."},{"issue":"3","key":"b6","series-title":"Neurosurgery","first-page":"475","article-title":"Cognitive functioning and health-related quality of life 1 year after aneurysmal subarachnoid hemorrhage in preoperative comatose patients (Hunt and Hess Grade V patients)","volume":"66","author":"Haug T","year":"2010","unstructured":"Haug T, Sorteberg A, Finset A, Lindegaard KF, Lundar T, Sorteberg W. Cognitive functioning and health-related quality of life 1 year after aneurysmal subarachnoid hemorrhage in preoperative comatose patients (Hunt and Hess Grade V patients). Neurosurgery. 2010;66(3):475\u2013485."},{"key":"b7","series-title":"World Neurosurg","first-page":"e527","article-title":"Risk factors for mild cognitive impairment in patients with aneurysmal subarachnoid hemorrhage treated with endovascular coiling","volume":"119","author":"Shen Y","year":"2018","unstructured":"Shen Y, Dong Z, Pan P, Shi H, Song Y. Risk factors for mild cognitive impairment in patients with aneurysmal subarachnoid hemorrhage treated with endovascular coiling. World Neurosurg. 2018;119:e527\u2013e533."},{"issue":"2","key":"b8","series-title":"Acta Neurochir (Wien)","first-page":"233","article-title":"Predicting return to work after subarachnoid hemorrhage using the Montreal Cognitive Assessment (MoCA)","volume":"158","author":"Wallmark S","year":"2016","unstructured":"Wallmark S, Ronne-Engstr\u00f6m E, Lundstr\u00f6m E. Predicting return to work after subarachnoid hemorrhage using the Montreal Cognitive Assessment (MoCA). Acta Neurochir (Wien). 2016;158(2):233\u2013239."},{"issue":"6","key":"b9","series-title":"Arch Clin Neuropsychol","first-page":"747","article-title":"The Montreal Cognitive Assessment: norms and reliable change indices for standard and MoCA-22 administrations","volume":"39","author":"Ratcliffe LN","year":"2024","unstructured":"Ratcliffe LN, Hale AC, McDonald T,  The Montreal Cognitive Assessment: norms and reliable change indices for standard and MoCA-22 administrations. Arch Clin Neuropsychol. 2024;39(6):747\u2013765."},{"issue":"1","key":"b10","series-title":"Alzheimers Dement (Amst)","first-page":"e12144","article-title":"T-MoCA: a valid phone screen for cognitive impairment in diverse community samples","volume":"13","author":"Katz MJ","year":"2021","unstructured":"Katz MJ, Wang C, Nester CO,  T-MoCA: a valid phone screen for cognitive impairment in diverse community samples. Alzheimers Dement (Amst). 2021;13(1):e12144."},{"issue":"11","key":"b11","series-title":"Article in Spanish. Rev Neurol","first-page":"317","article-title":"Usefulness of the Beck depression inventory in the diagnosis of depressive disorders in multiple sclerosis","volume":"78","author":"Aparicio-Castro E","year":"2024","unstructured":"Aparicio-Castro E, Candeliere-Merlicco A, Mar\u00eda Santa C, Villaverde-Gonz\u00e1lez R. Usefulness of the Beck depression inventory in the diagnosis of depressive disorders in multiple sclerosis. Article in Spanish. Rev Neurol. 2024;78(11):317\u2013322."},{"issue":"7","key":"b12","series-title":"Stroke","first-page":"1362","article-title":"Development of a stroke-specific quality of life scale","volume":"30","author":"Williams LS","year":"1999","unstructured":"Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a stroke-specific quality of life scale. Stroke. 1999;30(7):1362\u20131369."},{"issue":"8","key":"b13","series-title":"J Clin Exp Neuropsychol","first-page":"833","article-title":"Dimensions of personality disturbance after focal brain damage: investigation with the Iowa Scales of Personality Change","volume":"33","author":"Barrash J","year":"2011","unstructured":"Barrash J, Asp E, Markon K, Manzel K, Anderson SW, Tranel D. Dimensions of personality disturbance after focal brain damage: investigation with the Iowa Scales of Personality Change. J Clin Exp Neuropsychol. 2011;33(8):833\u2013852."},{"issue":"26","key":"b14","series-title":"N Engl J Med","first-page":"2456","article-title":"Making neighborhood-disadvantage metrics accessible\u2014The Neighborhood Atlas","volume":"378","author":"Kind AJH","year":"2018","unstructured":"Kind AJH, Buckingham WR. Making neighborhood-disadvantage metrics accessible\u2014The Neighborhood Atlas. 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