Affiliation:
1. N.V. Sklifosovsky Research Institute of Emergency Medical Care
2. Moscow State University of Medicine and Dentistry named after A.I. Evdokimov
3. Russian National Research Medical University named after N.I. Pirogov; City Clinical Hospital №4
4. N.V. Sklifosovsky Research Institute of Emergency Medical Care; Russian National Research Medical University named after N.I. Pirogov
Abstract
Assessment of patients with intracranial aneurysms in the late postoperative period consists of both determining structural changes in computed tomography (CT) and the neurological and cognitive status of the patient. Meantime, the topic of the relationship between structural pathology in CT and cognitive impairment has not been suffi ciently disclosed.Objective: to determine CT, functional and cognitive outcomes in the long-term period of surgical treatment of cerebral aneurysms.Material and methods. The data of CT angiography of 49 patients operated on for intracranial aneurysms were analyzed. 39 patients were examined neurologically for 2.3 years using a range of rating scales.Results. The residual part of the aneurysm after surgery was found in 50% of patients with complex aneurysms, more often in patients with PMA-PSA aneurysms. The connection between the method of surgery and the preserved cervical part with structural changes in the brain and the development of cognitive impairment in the late postoperative period has not been proven.Conclusion. CT angiography preoperatively makes it possible to identify a group of complex aneurysms with a high risk of preservation of the cervical part and the development of brain structural changes. The predictors of the development of ischemic changes in the brain, hydrocephalus, and cognitive dysfunctions was the advanced age of patients, the duration of the operation, and a history of hypertension.
Publisher
Medical Informational Agency Publishers
Subject
Psychiatry and Mental health,Neurology (clinical),Neurology
Reference22 articles.
1. Melnikova EA, Krylov VV. Cognitive disturbances after the operative treatment of intracranial arterial aneurisms in the acute stage of hemorrhage. S.S. Korsakov Journal of Neurology and Psychiatry. 2007;107(S21):16–24. (In Russ.).
2. Hackett ML, Anderson CS. Health outcomes 1 year after subarachnoid hemorrhage: An international population-based study. The Australian Cooperative Research on Subarachnoid Hemorrhage Study Group. Neurology. 2000;55(5):658–62. https://doi.org/10.1212/wnl.55.5.658
3. Kreiter KT, Copeland D Bernardini GL, Bates JE, Peery S, Claassen J et al. Predictors of cognitive dysfunction after subarachnoid hemorrhage. Stroke. 2002;33(1):200–8. https://doi.org/10.1161/hs0102.101080
4. Ogden JA, Mee EW, Henning M. A prospective study of impairment of cognition and memory and recovery after subarachnoid hemorrhage. Neurosurgery. 1993;33(4):572–86. https://doi.org/10.1227/00006123-199310000-00004
5. Krylov VV, Grigor’eva EV, Lukyanchikov VA, Polunina NA. Delayed postoperative changes after intracranial aneurysm surgery. Neurological Journal. 2018;23(5):241–247. (In Russ.). http://dx.doi.org/10.18821/1560-9545-2018-23-5-241-247