Early neuropsychological sequelae of aneurysm surgery and subarachnoid haemorrhage.
In order to disclose the immediate cognitive sequelae of early aneurysm surgery and subarachnoid haemorrhage (SAH), a series of 28 patients was examined neuropsychologically one to 13 days (median 5 days) after surgery. Cognitive deficits emerged in short- and long-term memory, language and in different functions of attention. There was no effect of ACoA aneurysm location on neuropsychological test performance. No substantial effect of premature aneurysm rupture or surgical approach could be revealed. Temporary clipping of vessels was associated with significantly worse selective attention and phasic alertness (p < 0.05, respectively). Partial resection of the gyrus rectus led to a worse short-term memory (p = 0.02). In regression analyses, the duration of temporary clipping was associated with worse short-term memory (adjusted r2 = 0.68; p = 0.007) and decreased phasic alertness (adjusted r2 = 0.47; p = 0.035). The clinical state on admission (Hunt and Hess) predicted an impaired phasic alertness (adjusted r2 = 0.43; p = 0.004). It is concluded from the results, that certain procedures and events in aneurysm surgery can have neuropsychological effects. The present study is restricted by the small sample size. Therefore, a prospective study with a larger patient sample is required for further confirmation of the present findings.
Hütter
B O
BO
Department of Neurosurgery, Technical University (RWTH) Aachen, Federal Republic of Germany.
Gilsbach
J M
JM
D000328:Adult; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000523:psychology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011379:Prognosis; D013345:Subarachnoid Hemorrhage / Q000523:psychology* / Q000601:surgery*; D013997:Time Factors