Impact of acute hydrocephalus after aneurysmal SAH on longitudinal cognitive outcome- post-hoc analysis of the MoCA-DCI study.
Bibliographic record
Abstract
Hydrocephalus is a common complication following aneurysmal subarachnoid hemorrhage (aSAH), associated with increased morbidity and mortality. While its immediate negative impact on cognitive function is well-known, the longitudinal effects, especially in lower-grade aSAH patients, remain unclear. This study aimed to assess these effects. Within the prospective, multicenter "MoCA-DCI study" (ClinicalTrials.gov NCT03032471), patients with a GCS of 13-15 < 72 h post-aSAH underwent serial neuropsychological assessments using the Montreal Cognitive Assessment (MoCA) at baseline (< 72 h post-aSAH), around discharge (14-28 days post-aSAH), and at 3-month follow-up. Standardized MoCA scores were compared to evaluate cognitive outcomes, and the likelihood of a clinically meaningful decline (≥ 2 points) was assessed in patients with and without hydrocephalus. We included 112 patients, mean age 53.9 years (SD 13.9), 66.1% female. Forty patients (35.7%) developed acute hydrocephalus and received external ventricular drainage; 10 of these (25%) required a ventriculo-peritoneal shunt. MoCA z-scores were significantly lower in the hydrocephalus group at baseline (-2.84 vs. -1.12, p < 0.001), at discharge (-3.35 vs. 0.53, p < 0.001), and at 3 months (-0.68 vs. 0.07, p = 0.02). Patients with hydrocephalus were more likely to experience a ≥ 2-point decline from baseline at discharge (OR 2.76, 95% CI 1.16-6.53; p = 0.02) but not at the 3-month follow-up (OR 1.22, 95% CI 0.32-4.62; p = 0.77). Acute hydrocephalus has a negative impact on longitudinal neurocognitive function, yet patients demonstrate improvements until 3-month follow-up. The impairment of cognitive function may be partially recovered as cerebrospinal fluid flow is restored or permanently diverted.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".