2024 Volume 52 Issue 6 Pages 448-452
With the increase in life expectancy, the number of surgeries for unruptured aneurysms in older patients is increasing. However, the effects of clipping surgery on their cognitive function have not yet been adequately studied. Herein, we report our results and review the risk factors for postoperative cognitive decline in these patients. This study included 97 patients aged 75 years or older who underwent clipping surgery for unruptured aneurysms in our hospital between 2018 and 2022. We examined the Mini-Mental State Examination (MMSE) and Hasegawa's Dementia Scale-Revised (HDS-R) scores preoperatively and within 2 weeks postoperatively as well as the risk factors for patients with a decrease of score of at least 3 points in either of the assessments. Of the 97 patients, 11 were male and 86 were female, and the mean age was 78.4 years. The average aneurysm size was 5.9 mm, and the aneurysms were located in the anterior cerebral, middle cerebral, and internal carotid arteries (approximately 30% each) and in the posterior circulation (6%). The average MMSE scores were 27.1 points preoperatively and 26.4 points postoperatively, and the average HDS-R scores were 27.1 points preoperatively and 26.4 points postoperatively, with no significant decrease postoperatively in either assessments. Diabetes mellitus and preoperative modified Rankin Scale score ≥ 1 were risk factors for postoperative cognitive decline. In conclusion, with proper patient selection, clipping surgery can be performed in older patients without compromising their cognitive function..
