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Cognitive deficits after rupture and early repair of anterior communicating artery aneurysms

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Summary

In a retrospective follow-up study covering a time period of four years 18 patients operated upon early for an aneurysm of the anterior communicating artery (ACoA) and a control group of 21 patients with aneurysmal subarachnoid haemorrhage (SAH) from other sources than ACoA aneurysm and 9 patients with SAH of nonaneurysmal origin were subjected to neuropsychological examination. Both groups were comparable in their neurological condition on admission and in the severity of bleeding seen on CT-scan. Testing included memory functions, concentration, logical and spatial thinking, a Stroop-test, an aphasia screening test and a complex choice reaction task. Patients with SAH of a ruptured ACoA aneurysm did not differ significantly from the control group in any of the tests used. But there was a trend for the ACoA patients to have more memory problems than the patients with SAH of other origins. On the other hand the patients in the control group with aneurysmal SAH of other locations and with non-aneurysmal SAH had not significantly more problems with concentration and aphasia than the patients with ruptured ACoA aneurysm. These results, which differ from the common opinion of frequent occurrence of memory deficits in ACoA aneurysms are interpreted as a consequence of the changes in improved pre-, intra- and postoperative management in modern neurosurgery.

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References

  1. Alexander MP, Freedman M (1984) Amnesia after anterior communicating artery aneurysm rupture. Neurology 34: 752–757

    Google Scholar 

  2. Amthauer R (1955) Der Intelligenz-Struktur-Test IST, 2nd Ed. Verlag für Psychologie, Dr. CJ Hogrefe, Göttingen

    Google Scholar 

  3. Bäumler G (1985) Der Farbe-Wort-Interferenztest (FWIT). Verlag für Psychologie, Dr. CJ Hogrefe, Göttingen

    Google Scholar 

  4. Benton AL (1981) Der Benton-Test. Huber, Bern Stuttgart Wien

    Google Scholar 

  5. Benton AL (1985) Reaction time in brain disease: some reflections. Cortex 21: 129–140

    Google Scholar 

  6. Bornstein RA, Weir BKA, Petruk KC, Disney LB (1987) Neuropsychological function in patients after subarachnoid haemorrhage. Neurosurgery 21: 651–654

    Google Scholar 

  7. Brickenkamp R (1978) Test d2 Aufmerksamkeits-Belastungs-Test. Verlag für Psychologie, Dr. CJ Hogrefe, Göttingen

    Google Scholar 

  8. Crowell RM, Morawetz RB (1977) The anterior communicating artery has significant branches. Stroke 8: 272–273

    Google Scholar 

  9. Dahl G (1972) WIP-Revidierter Wechseler Intelligenztest. Hain-Verlag, Meisenheim

    Google Scholar 

  10. Fisher CM, Kistler JP, Davis JM (1980) Relation of cerebral vasospasm to subarachnoid haemorrhage visualized by computerized tomographic scanning. Neurosurgery 6: 1–9

    Google Scholar 

  11. Freckmann N, Arnold H, Nowack G, Winkler D (1985) Fortschritte in der Behandlung von Subarachnoidalblutungen nach Aneurysmaruptur. Psycho: 408–411

  12. Gade A (1982) Amnesia after operations on aneurysms of the anterior communicating artery. Surg Neurol 18: 46–49

    Google Scholar 

  13. Gilsbach JM, Reulen HJ, Ljunggren B, Brandt L, von Holst H, Mokry M, von Essen C, Conzen MA (1990) Early aneurysm surgery and preventive therapy with intravenous nimodipine: a multicenter, double-blind, dose comparison study. Neurosurgery 26: 458–464

    Google Scholar 

  14. Gomez FB, Dujovny M, Umansky F, Berman SK, Diaz FG, Ausman JI, Mirchandani HG, Ray WJ (1986) Microanatomy of the anterior cerebral artery. Surg Neurol 26: 129–141

    Google Scholar 

  15. Gurusinghe NT, Richardson AE (1984) The value of computerized tomography in aneurysmal subarachnoid haemorrhage. The concept of the CT score. J Neurosurg 60: 763–770

    Google Scholar 

  16. Heaton RK, Pendleton MG (1981) Use of neuropsychological tests to predict adult patients every day functioning. J Consult Clin Psychol 49: 807–821

    Google Scholar 

  17. Horn W (1983) Das Leistungsprüfsystem LPS. Verlag für Psychologie, Dr. CJ Hogrefe, Göttingen

    Google Scholar 

  18. Hunt WE, Hess RM (1968) Surgical risc as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg 28: 14–20

    Google Scholar 

  19. Jennett B, Bond M (1975) Assessment of outcome after severe brain damage. A practical scale. Lancet 1: 480–484

    Google Scholar 

  20. Kapur N, Coughlan AK (1980) Confabulation and frontal lobe dysfunction. J Neurol Neurosurg Psychiatry 43: 461–463

    Google Scholar 

  21. Klebelsberg D (1960) Das Wiener Determinationsgerät. Diagnostica 6: 165–166

    Google Scholar 

  22. Lezak MD (1983) Neuropsychological assessment, 2nd Ed. Oxford University Press, New York

    Google Scholar 

  23. Logue V, Durward M, Pratt RTCet al (1968) The quality of survival after rupture of an anterior cerebral aneurysm. Br J Psychiat 114: 137–160

    Google Scholar 

  24. Marinkovic S, Milisavljevic M, Marinkovic (1990) Branches of the anterior communicating artery. Acta Neurochir (Wien) 106: 78–85

    Google Scholar 

  25. Norlen G, Olivecrona H (1953) The treatment of aneurysms of the circle of Willis. J Neurosurg 10: 404–415

    Google Scholar 

  26. Nyström SHM (1973) Psychodynamics in subarachnoid haemorrhage. Sahalankirjapaino, Helsinki

    Google Scholar 

  27. Okawa K, Maeda S, Nukui H, Kawafuchi J (1980) Psychiatric symptoms in ruptured anterior communicating artery aneurysms: social prognosis. Acta Psychiatr Scand 61: 306–312

    Google Scholar 

  28. Orgass B (1982) Deutsche Bearbeitung des Token Tests von E. Derenzi und L. A. Vignolo. Beltz, Weinheim

    Google Scholar 

  29. Papez JW (1937) A proposed mechanism of emotion. Arch Neurol Psychiat 38: 725–744

    Google Scholar 

  30. Perlmutter D, Rhoton AL (1976) Microsurgical anatomy of the anterior cerebral-anterior communicating-recurrent artery complex. J Neurosurg 45: 259–272

    Google Scholar 

  31. Rauchfleisch U (1983) Zur Rehabilität und Validität des Aufmerksamkeitsbelastungstests bei Patienten mit hirndiffusem Psychosyndrom und neurotischen Störungen. Diagnostica 24: 247–255

    Google Scholar 

  32. Richardson JT (1989) Performance in the recall following rupture and repair of intracranial aneurysm. Brain Cogn 9: 210–226

    Google Scholar 

  33. Sengupta RP, Chiu JSP, Brierley H (1975) Quality of survival following direct surgery for anterior communicating artery aneurysms. J Neurosurg 43: 58–66

    Google Scholar 

  34. Sonesson B, Ljunggren B, Säveland H, Brandt L (1987) Cognition and adjustment after late and early operation for ruptured aneurysm. Neurosurgery 21: 279–287

    Google Scholar 

  35. Sonesson B, Säveland H, Ljunggren B, Brandt L (1989) Cognitive functioning after subarachnoid haemorrhage of unknown origin. Acta Neurol Scand 78: 54–59

    Google Scholar 

  36. Stolke D, Seifert V (1988) Frühoder Spätoperation des rupturierten Aneurysmas? Eine Analyse anhand von 356 Fällen. Neurochirurgica 31: 81–87

    Google Scholar 

  37. Stuss DT, Alexander MP, Liebermann A, Levine H (1978) An extraordinary form of confabulation. Neurology 28: 1166–1172

    Google Scholar 

  38. Stuss DT, Kaplan EF, Benson DF, Weir WS, Chiulli S, Sarazin FF (1982) Evidence for the involvement of orbitofrontal cortex in memory functions: an interference effect. J Comp Physiol Psychol 96: 913–925

    Google Scholar 

  39. Stuss DT, Ely P, Hugenholtz H, Richard T, LaRochelle S, Poirier CA, Bell I (1985) Subtle neuropsychological deficits in patients with good recovery after closed head injury. Neurosurgery 17: 41–46

    Google Scholar 

  40. TÜV-Baden (1976) VO/TÜV/MPI Testnormen für das Wiener Determinationsgerät. TÜV-Baden, Freiburg

    Google Scholar 

  41. Talland GA, Sweet WH, Ballantine HT (1967) Amnesic syndrome with anterior communicating artery aneurysm. J Nerv Ment Dis 145: 179–192

    Google Scholar 

  42. Van Zomeren AH, Vandenburg W (1985) Residual impairments of patients two years after severe head injury. J Neurol Neurosurg Psychiatry 48: 21–28

    Google Scholar 

  43. Vilkki J (1985) Amnesic syndromes after surgery of anterior communicating artery aneurysms. Cortex 21: 431–444

    Google Scholar 

  44. Vincentelli F, Lehman G, Caruso G, Grisoli F, Rabehanta P, Gouaze A (1991) Extracerebral course of the perforating branches of the anterior communicating artery: microsurgical anatomical study. Surg Neurol 35: 98–104

    Google Scholar 

  45. Volpe BT, Hirst W (1983) Amnesia following rupture and repair of an anterior communicating artery aneurysm. J Neurol Neurosurg Psychiatry 46: 704–709

    Google Scholar 

  46. Yasargil MG, Fox JL (1975) The microsurgical approach to intracranial aneurysms. Surg Neurol 3: 7–14

    Google Scholar 

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Authors and Affiliations

  1. Neurosurgical Department, Technical University (RWTH) Aachen, Federal Republic of Germany

    B. O. Hütter & J. M. Gilsbach

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  1. B. O. Hütter
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  2. J. M. Gilsbach
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Hütter, B.O., Gilsbach, J.M. Cognitive deficits after rupture and early repair of anterior communicating artery aneurysms. Acta neurochir 116, 6–13 (1992). https://doi.org/10.1007/BF01541247

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