TIMING OF OPERATION FOR RUPTURED CEREBRAL ANEURYSM AND LONG-TERM RECOVERY OF COGNITIVE FUNCTIONS

Advantages and disadvantages of early and late operation for ruptured cerebral aneurysm are controversially evaluated with regard to peri-op erative operation outcome and long-term cognitive recovery. In this re trospective analysis 22 patients with early surgery (ES) within three days after subarachnoid haemorrhage (SAH) and 22 patients with late su rgery (LS) al least 14 days after SAH were studied. Patients were pair -wise matched by degree of SAH, localisation of aneurysm and age at SA H. On average three years after SAH both groups were examined individu ally with a comprehensive neuropsychological rest battery including te sts of premorbid intelligence. concept formation, memory, visuomotor s peed, aphasia screening, and mood. ES and LS patients were well compar able in terms of years of education and level of premorbid intelligenc e. There was a clear influence of patients age on fluid intelligence t ests, indicating a general change-sensitivity of tests. No influence o f degree of SAH and localisation of aneurysm could be detected. There were also no differences between ES and LS patients in neuropsychologi cal tests sensitive to brain damage, suggesting that the decision for early or late surgery for ruptured cerebral aneurysm can be based upon surgical reasons at the time of the SAH.