Surgical Neurology
Volume 72, Issue 6 , Pages 592-595, December 2009

Comparison of postoperative cognitive function in patients undergoing surgery for ruptured and unruptured intracranial aneurysm

  • Yasunari Otawara, MD

      Affiliations

    • Department of Neurosurgery, Iwate Medical University, Morioka, Iwate 020-8505, Japan
    • Corresponding Author InformationCorresponding author. Tel.: +81 19 651 5111; fax: +81 19 625 8799.
    • ,
  • Kuniaki Ogasawara, MD

      Affiliations

    • Department of Neurosurgery, Iwate Medical University, Morioka, Iwate 020-8505, Japan
    • ,
  • Yoshitaka Kubo, MD

      Affiliations

    • Department of Neurosurgery, Iwate Medical University, Morioka, Iwate 020-8505, Japan
    • ,
  • Hiroshi Kashimura, MD

      Affiliations

    • Department of Neurosurgery, Iwate Medical University, Morioka, Iwate 020-8505, Japan
    • ,
  • Akira Ogawa, MD

      Affiliations

    • Department of Neurosurgery, Iwate Medical University, Morioka, Iwate 020-8505, Japan
    • ,
  • Keiko Yamadate, BSc

      Affiliations

    • Department of Clinical Psychology, Tochinai Daini Hospital, Takizawa, Iwate 020-0151, Japan

Received 24 January 2009; accepted 17 June 2009.

Abstract 

Background

Patients with SAH often experience cognitive decline. Previous studies used normal volunteers, published normal test values, and orthopedic patients as controls to identify factors for postoperative cognitive decline. The present study excluded the effects of surgery by comparing cognitive function after surgical repair in patients with aneurysmal SAH and patients with unruptured intracranial aneurysm.

Methods

This study recruited 117 patients with SAH due to ruptured aneurysm and 39 patients with incidentally found unruptured intracranial aneurysms. The cognitive test battery consisted of the Japanese translation of the WAIS-R, the Japanese translation of the WMS, and the recall trial of the ROCF. Postoperative neuropsychological test scores for the patients with SAH and control subjects were compared using group-rate and event-rate analysis. The relationship between clinical variable and postoperative cognitive decline in the patients with SAH was evaluated by univariate analysis using the Mann-Whitney U test or χ2 test.

Results

Group-rate analysis showed that the WAIS-R and ROCF scores were significantly lower in the SAH group than in the control group. Event-rate analysis demonstrated that the incidence of cognitive decline in the patients with SAH (73 [62.4%] of the 117 patients) was significantly higher than that in the control subjects (12 [30.8%] of 39 patients). The Hunt and Hess grade was significantly higher in patients with postoperative cognitive decline.

Conclusion

The cognitive function after SAH was significantly correlated with Hunt and Hess grade on admission when using patients with postoperative unruptured intracranial aneurysm as the control group.

Abbreviations: CT, computed tomography, IQ, intelligence quotient, ROCF, Rey-Osterreith Complex Figure test, SAH, subarachnoid hemorrhage, WAIS-R, Wechsler Adult Intelligence Scale–Revised, WMS, Wechsler Memory Scale.

Keywords: Ruptured intracranial aneurysm, Cognition, Surgery

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S0090-3019(09)00581-3

doi:10.1016/j.surneu.2009.06.016

Surgical Neurology
Volume 72, Issue 6 , Pages 592-595, December 2009

Article Tools