Neuropsychological outcome of operated cerebral aneurysms: prognostic factors on 148 patients.
OBJECTIVE
To analyse prognostic factors in patients operated upon for cerebral aneurysms. A previous investigation by our group showed that patients operated later than 10 days after bleeding have a worse neuropsychological prognosis, but the number of patients operated upon within 3 days was not sufficient. Here, a new sample of patients with early surgery is included in the analyses.


METHODS
Patients numbered 148 (65 with ACoA, 39 with MCA, and 44 with PCoA aneurysms): 56 were operated within 3 days, 44 within 4-10 days, and 48 after at least 10 days from bleeding. A standardized battery of 13 neuropsychological tests was adopted: we considered both the number of defective scores and the average performance.


RESULTS
Patients operated later than 10 days after bleeding had a worse prognosis than the 2 groups with early and intermediate surgery, which were not different. Aneurysm site was not relevant. Old age and low education were associated with a worse prognosis. Hunt and Hess scores at operation and post operation were also predictive of the outcome.


CONCLUSIONS
On the whole, patients operated upon later than 10 days after bleeding have a less favourable prognosis than those with earlier operation timing.
Istituto di Neurochirurgia, Milan University, Ospedale Policlinico, IRCCS, Italy.
A
A
De Santis
M
M
Laiacona
R
R
Barbarotto
O
O
De Divitiis
M
M
Migliore
E
E
Capitani
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011379:Prognosis; D012189:Retrospective Studies