Microsurgical clipping in forty patients with unruptured anterior cerebral circulation aneurysms: an investigation into cognitive outcome.
OBJECTIVE
It is a consensus that most unruptured intracranial aneurysms (UIA) can be treated with acceptably low morbidity. However, some studies recently reported postoperative cognitive impairment, suggesting that it could be attributable to surgical damage. Our goal is to evaluate cognitive function before and after microsurgical clipping in patients with UIA.


METHODS
A consecutive series of 40 patients who underwent microsurgical clipping for UIA were studied. The cognitive assessment (Mini Mental State Examination, MMSE) was performed immediately before and at least one month after surgery. Paired Student's "t" test and analysis of variance (ANOVA) were used for statistical purposes.


RESULTS
The mean MMSE score in the preoperative analysis was 28.12 (SD, 1.34). In the postoperative period the mean MMSE score was 28.40 (SD, 1.46). Paired Student's "t" test was applied to the scores and no significant difference was found (p = 0.315). ANOVA did not find independent associations between MMSE scores and age, hypertension, smoking, dyslipidemia, education, aneurysm location, number, laterality or size.


CONCLUSIONS
The present study suggests that microsurgical clipping for UIA does not result in major cognitive dysfunction as determined by the MMSE.
School of Medicine, Neurosciences Post-Graduation Program, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil. arthurpereiraflho@gmail.com
Arthur A
AA
Pereira-Filho
Adriana G
AG
Pereira
Mário B
MB
Faria
Leonardo C S
LC
Lima
Mirna W
MW
Portuguez
Jorge L
JL
Kraemer
D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D013525:Surgical Instruments / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult