Aphasia associated with non-traumatic subarachnoid haemorrhage: a systematic review

Abstract

Purpose

Individuals with non-traumatic subarachnoid haemorrhage (SAH) are often excluded from studies of stroke populations due to differing pathophysiology and treatment pathways. Thus, aphasia presentation in the non-traumatic SAH population is potentially under-represented within existing research evidence.

Materials and methods

Five databases were systematically searched with terms related to “aphasia” and “subarachnoid haemorrhage.” Studies were included if aphasia was attributed to non-traumatic SAH or its associated complications, and where at least one language assessment measure used determined the presence or absence of aphasia. Study quality was evaluated using the Mixed Methods Appraisal Tool (MMAT).

Results

Following deduplication, 2726 articles were identified for title and abstract screening. Full text screening for 162 articles occurred, with 18 articles selected for inclusion. Aphasia incidence ranged from 5 to 24%, and was influenced by assessment measure, timing of assessment, subgroup studied, and classifications of aphasia. Many studies excluded participants with poorer clinical outcome, intracerebral complications, or severe aphasia. Few studies used comprehensive language assessment measures to examine across language domains.

Conclusions

Aphasia presentation is highly heterogenous following non-traumatic SAH. Future research using comprehensive language assessments at multiple time points post onset is required to better understand aphasia presentation and management needs for this population.

Implications for Rehabilitation

• Aphasia screening and/or assessment should be routinely performed for all individuals following non-traumatic subarachnoid haemorrhage (SAH).

• Comprehensive assessment across all language domains is required to ascertain the nature and extent of aphasia.

• Co-occurring cognitive deficits are likely in the SAH population.

Keywords:

• subarachnoid haemorrhage
• aphasia
• systematic review
• stroke
• language

Acknowledgement

The authors wish to thank Penelope Ganzenmuller, Ipswich Hospital Librarian, for her assistance with database searching.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.