抄録
This study demonstrated cognitive impairment among a group of patients undergoing open surgery for ruptured anterior communicating artery (Acom) aneurysms. We used the Wechsler Adult Intelligence Scale-Revised (WAIS-R), Wechsler Memory Scale-Revised (WMS-R), and Wisconsin Card Sorting Test (WCST) for the neuropsychological assessment. WAIS-R is one of the most famous assessment tools for cognitive impairment and is widely used because it has become the published norm and was evaluated by intelligence quotient.
The subjects comprised 51 of 241 patients who recovered social life with the rupture of Acom aneurysms that had been clipped neurosurgically between April 1, 1982, and July 31, 2000. The WAIS-R score showed impairment in 12 patients (24%), the WMS-R score showed impairment in 20 patients (39%) and the WCST score showed impairment in 33 patients (65%), the highest impairment rate in these tests. None of these patients showed impairment only in the WAIS-R. There was no significant correlation between the various clinical factors such as the age, Hunt & Kosnik grading, Fisher group, approach side, infarction, shunt, removal of gyrus rectus and the neuropsychological impairment. However, there was a significant correlation between the age and the WCST score.
Although it was difficult to detect the cause of cognitive impairment, some causes are associated with SAH itself whereas others are due to medial frontal lobe disorder for general effects of neurosurgery or other factors such as the disturbance of the perforating arteries.
