IS THERE A GROUP OF EARLY SURGERY ANEURYSMAL SAH PATIENTS WHO CAN EXPECT TO ACHIEVE A COMPLETE LONG-TERM NEUROPSYCHOLOGICAL RECOVERY

There is a significant controversy regarding the effect of early surgi cal intervention for microsurgical aneurysm clipping on long-term cogn itive recovery. Although new strategies in surgical and medical manage ment have progressively reduced the morbidity and mortality rates rela ted to subarachnoid haemorrhage (SAH), the overall quality of life of aneurysm patients has been reported to remain unsatisfactory. In fact, even in the presence of a good neurological recovery following an ane urysmal SAH, patients may show persistent emotional and psychological disturbances. The aim of this study was to analyse the long-term cogni tive, neuropsychological and emotional status of a group of patients, subjected to early surgery aneurysm treatment: and having SAH characte ristics generally considered predictive of a favourable outcome. Patie nts were submitted to a complete battery of neuropsychological tests d esigned to assess a full range of cognitive and attentional functions. The results of the neuropsychological evaluation did not detect evide nce of any significant cognitive deterioration as compared to control volunteers and to the published age-adjusted test norms. These results indicate that early aneurysm surgery, coupled with modern microneuros urgical techniques and aggressive medical management is associated wit h a good neurological outcome and a full recovery of cognitive, neurop sychological and emotional performances in a subset of patients with f avourable clinical characteristics.