Outcome and rehabilitation after aneurysmal subarachnoid haemorrhage

108 consecutive and unselected patients presenting with subarachnoid haemorrhage (SAH) due to cerebral aneurysm rupture were treated with a standardized regime. At 12 months after surgery 87 patients, who were available for review, were investigated with questionnaires, physical examination and neuropsychological tests. On the background of a comparatively low physical morbidity rate of 7% and mainly normal test results for concentration abilities, non-verbal memory function, word knowledge, logic and 3-dimensional thought, delay in rehabilitation was evidently caused by psychological problems. These were most manifest in increased anxiety, personality changes in form of depression or aggression, and lack of social contact and were exacerbated by apparently inadequate postoperative care. Therefore a psychologist should be involved during the first 12 months of rehabilitation, clinics should be held more frequently or access via phone to a neurosurgical information centre should be provided. The presented follow-up concept is suitable for assessing rehabilitation but for practical reasons should be shortened.