title: Effects of preventive surgery for unruptured intracranial aneurysms on attention, executive function, learning and memory: a prospective cohort study.
abstract: BACKGROUND
  We prospectively evaluated the effects of preventive surgery for unruptured intracranial aneurysms on attention, executive function, learning and memory.
  
  
  METHODS
  Between March 2012 and June 2013, 56 patients were recruited for this study. Fifty-one patients met the inclusion criteria and were enrolled. Inclusion criteria were as follows: (1) age ≤65 years and (2) planned microsurgery or endovascular surgery for unruptured intracranial aneurysm. Exclusion criteria were as follows: (1) preoperative intelligence quotient <80 (n = 3); (2) initial modified Rankin scale ≥1 (n = 1); (3) loss to follow-up (n = 1). An auditory controlled continuous performance test (ACCPT), word-color test (WCT) and verbal learning test (VLT) were performed before and after (6 months) preventive surgery.
  
  
  RESULTS
  ACCPT (attention), WCT (executive function) and VLT (learning and memory) scores did not change significantly between the pre- and postoperative evaluations. The ACCPT, WCT, total VLT scores (verbal learning) and delayed VLT scores (memory) did not differ significantly between patients undergoing microsurgery and those undergoing endovascular surgery. However, ACCPT, WCT and delayed VLT scores decreased postoperatively in patients with leukoaraiosis on preoperative FLAIR images (OR 9.899, p = 0.041; OR 11.421, p = 0.006; OR 2.952, p = 0.024, respectively).
  
  
  CONCLUSIONS
  Preventive surgery for unruptured intracranial aneurysms did not affect attention, executive function, learning or memory. However, patients with leukoaraiosis on FLAIR images might be prone to deficits in attention, executive function and memory postoperatively, whereas learning might not be affected.
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 135-720, Republic of Korea.|Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Joonho
authors.initials: J
authors.lastname: Chung
authors.affiliation: Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jeong-Ho
authors.initials: JH
authors.lastname: Seok
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 135-720, Republic of Korea.
authors.forename: Min A
authors.initials: MA
authors.lastname: Kwon
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 135-720, Republic of Korea.
authors.forename: Yong Bae
authors.initials: YB
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 135-720, Republic of Korea.
authors.forename: Jin-Yang
authors.initials: JY
authors.lastname: Joo
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 135-720, Republic of Korea. yedamin@yuhs.ac.|Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Republic of Korea. yedamin@yuhs.ac.
authors.forename: Chang-Ki
authors.initials: CK
authors.lastname: Hong
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D007858:Learning / Q000502:physiology*; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D065286:Prophylactic Surgical Procedures / Q000009:adverse effects*; D011446:Prospective Studies
keywords: Brain dysfunction; Endovascular coiling; Intracranial aneurysms; Microsurgical clipping; Unruptured aneurysms