Editorial: standard neuropsychological assessments in neurosurgery

Excerpt

In this issue of Acta Neurochirurgica, Zweifel-Zehnder et al. [2] recommend routine screening of SAH patients with a standardized set of neuropsychological assessments. Their project is highly applaudable and represents at the same time a substantial challenge. Neurosurgeons pay keen attention to neurological deficits easily recognized by standard neurological examination. We recognize prominent symptoms such as paresis, visual field deficits, sensory disturbances, and marked cognitive deficits, i.e., severe aphasia, memory disturbances, and overt executive function disturbances. However, mild and moderate cognitive deficits and behavioral changes are easily overlooked. Often these symptoms do not present themselves on the ward where there are only restricted demands on the patient’s cognition and active participation in daily activities. Failure to identify cognitive deficits is likely to have dire consequences for the patient and their relatives. Families may break up, and patients may lose their jobs. These consequences could be avoided if the cognitive dysfunctions are identified and relevant rehabilitation is initialized. Perhaps the most important issue is that the patient, the family, and the employers are supported in adapting to the new situation. We often refer to pertinent early identification of cognitive deficits as “mind the gap”—the gap between the neurosurgical standard of being “neurosurgical intact” and standard of performance needed to be reintegrated in normal life. …