• Neurosurgery · May 2019

    Multicenter Study Observational Study

    Measuring the Impact of Delayed Cerebral Ischemia on Neuropsychological Outcome After Aneurysmal Subarachnoid Hemorrhage-Protocol of a Swiss Nationwide Observational Study (MoCA-DCI Study).

    • Martin N Stienen, Christian Fung, Philippe Bijlenga, Daniel W Zumofen, Rodolfo Maduri, Thomas Robert, Martin A Seule, Serge Marbacher, Olivia Geisseler, Peter Brugger, Klemens Gutbrod, Christian Chicherio, Andreas U Monsch, Valérie Beaud, Stefania Rossi, Severin Früh, Nicole Schmid, Nicolas R Smoll, Emanuela Keller, Luca Regli, and MoCA-DCI study group.
    • Department of Neurosurgery, University Hospital Zurich, Clinical Neuroscience Center, University of Zurich, Switzerland.
    • Neurosurgery. 2019 May 1; 84 (5): 1124-1132.

    BackgroundThe exact relationship between delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH) and neuropsychological impairment remains unknown, as previous studies lacked a baseline examination after aneurysm occlusion but before the DCI-period. Neuropsychological evaluation of acutely ill patients is often applied in a busy intensive care unit (ICU), where distraction represents a bias to the obtained results.ObjectiveTo evaluate the relationship between DCI and neuropsychological outcome after aSAH by comparing the Montreal Cognitive Assessment (MoCA) results in aSAH patients with and without DCI at 3 mo with a baseline examination before the DCI-period (part 1). To determine the reliability of the MoCA, when applied in an ICU setting (part 2).MethodsProspective, multicenter, and observational study performed at all Swiss neurovascular centers. For part 1, n = 240 consecutive aSAH patients and for part 2, n = 50 patients with acute brain injury are recruited.Expected OutcomesPart 1: Effect size of the relationship between DCI and neuropsychological outcome (MoCA). Part 2: Reliability measures for the MoCA.DiscussionThe institutional review boards approved this study on July 4, 2017 under case number BASEC 2017-00103. After completion, the results will be offered to an international scientific journal for peer-reviewed publication. This study determines the exact impact of DCI on the neuropsychological outcome after aSAH, unbiased by confounding factors such as early brain injury or patient-specific characteristics. The study provides unique insights in the neuropsychological state of patients in the early period after aSAH.Copyright © 2018 by the Congress of Neurological Surgeons.

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