Fatigue after subarachnoid haemorrhage: A systematic review

Abstract 

Background

Fatigue is common and debilitating symptom in many neurological disorders and it has been reported in patients after non-traumatic subarachnoid haemorrhage (SAH).

Objectives

We undertook a systematic review to identify and critically appraise all published studies that have reported frequency, severity and time course of fatigue after SAH, the factors associated with its development and the impact of fatigue on patients' life after SAH.

Methods

We searched Medline, EMBASE, CINAHL, PsycINFO, AMED, PubMed and included in the review all studies published in English, recruiting at least 10 patients (>18years old) after SAH, which reported fatigue.

Results

We identified 13 studies (total number of subjects 737) meeting our inclusion criteria. The frequency of fatigue ranged from 31 to 90%. Fatigue remained common even several years after the ictus. According to some studies fatigue after SAH was associated with sleep disturbances, anxiety, depression, posttraumatic stress disorder, cognitive and physical impairment, but these could not explain all cases of fatigue. Fatigue reduces quality of life and life satisfaction in patients after SAH.

Conclusions

Fatigue is common after SAH and seems to persist. Further research is needed to clarify its time course and identify factors associated with its development.

Keywords: Fatigue, Subarachnoid haemorrhage, Long-term outcomes