EARLY NEUROPSYCHOLOGICAL SEQUELAE OF ANEURYSM SURGERY AND SUBARACHNOID HEMORRHAGE

In order to disclose the immediate cognitive sequelae of early aneurys m surgery and subarachnoid haemorrhage (SAH), a series of 28 patients was examined neuropsychologically one to 13 days (median 5 days) after surgery. Cognitive deficits emerged in short- and long-term memory, l anguage and in different functions of attention. There was no effect o f ACoA aneurysm location on neuropsychological test performance. No su bstantial effect of premature aneurysm rupture or surgical approach co uld be revealed. Temporary clipping of vessels was associated with sig nificantly worse selective attention and phasic alertness (p < 0.05, r espectively). Partial resection of the gyrus rectus led to a worse sho rt-term memory (p = 0.02). In regression analyses, the duration of tem porary clipping was associated with worse short-term memory (adjusted r(2) = 0.68; p = 0.007) and decreased phasic alertness (adjusted r(2) = 0.47; p = 0.035). The clinical state on admission (Hunt and Hess) pr edicted an impaired phasic alertness (adjusted r(2) = 0.43; p = 0.004) . It is concluded from the results, that certain procedures and events in aneurysm surgery can have neuropsychological effects. The present study is restricted by the small sample size. Therefore, a prospective study with a larger patient sample is required for further confirmati on of the present findings.