Introduction: The aim of the paper was to assess a character, magnitude and dynamism of neuropsychological disorders in patients operated on for intracranial aneurysms located either on anterior communicating or posterior communicating arteries. We attempted to establish the usefulness of the Hunt and Hess grading as a predictor of subsequent postoperative neuropsychological disorders. Material and methods: To this study 82 patients with SAH from a single aneurysm located either on the anterior or posterior communicating arteries were enrolled. Directly before surgery the patients were assessed according to Hunt and Hess grading and only those assigned to grades I, II and III were taken into consideration. Neurological outcome of all these patients a discharge was described as good (GOS 4-5). The neuropsychological tests were carried out first about three weeks after the surgery and again six months later. Results: Compared to average results found in the population, our patients displayed decreased scores in the range of all functions examined with Wechsler Intelligence Scale. This was particularly true in patients Hunt and Hess grade III. Neuropsychological tests six months after the surgery confirmed apparent dynamics of the changes, particularly in the non-verbal tests. Conclusions: Hunt and Hess grading proved to be of satisfying prognostic value for future neuropsychological disorders. As a rule, Hunt and Hess grade I and II patients achieved better results in neuropsychological tests then those grade III. The only exception was noted in the case of the factor of the susceptibility to distraction, where the results were below average in all patients, both directly and six months after the surgery. 

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Neuropsychological assessment of early and long-term outcome after operative treatment in patients with bleeding from anterior or posterior communicating artery aneurysms

Elżbieta A. Ormezowska, Marek Zawirski, Dariusz J. Jaskólski

Affiliation and address for correspondence
Aktualn Neurol 2007, 7 (4), p. 270-276
Abstract

Introduction: The aim of the paper was to assess a character, magnitude and dynamism of neuropsychological disorders in patients operated on for intracranial aneurysms located either on anterior communicating or posterior communicating arteries. We attempted to establish the usefulness of the Hunt and Hess grading as a predictor of subsequent postoperative neuropsychological disorders. Material and methods: To this study 82 patients with SAH from a single aneurysm located either on the anterior or posterior communicating arteries were enrolled. Directly before surgery the patients were assessed according to Hunt and Hess grading and only those assigned to grades I, II and III were taken into consideration. Neurological outcome of all these patients a discharge was described as good (GOS 4-5). The neuropsychological tests were carried out first about three weeks after the surgery and again six months later. Results: Compared to average results found in the population, our patients displayed decreased scores in the range of all functions examined with Wechsler Intelligence Scale. This was particularly true in patients Hunt and Hess grade III. Neuropsychological tests six months after the surgery confirmed apparent dynamics of the changes, particularly in the non-verbal tests. Conclusions: Hunt and Hess grading proved to be of satisfying prognostic value for future neuropsychological disorders. As a rule, Hunt and Hess grade I and II patients achieved better results in neuropsychological tests then those grade III. The only exception was noted in the case of the factor of the susceptibility to distraction, where the results were below average in all patients, both directly and six months after the surgery. 

Keywords
subarachnoid hemorrhage, intracranial aneurysm, neuropsychological evaluation, Hunt and Hess grade, Wechsler Intelligence Scale

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