Measuring of Cognitive Deficit after Cerebral Aneurysm Intervention
Authors:
L. Krámská 1; M. Preiss2 ,3; J. Hradil 4
Authors‘ workplace:
Neurologické oddělení, Nemocnice Na Homolce, Praha
1; Psychiatrické centrum Praha
2; University of New York, Praha
3; Neurochirurgie, Krajská nemocnice Liberec, a. s.
4
Published in:
Cesk Slov Neurol N 2012; 75/108(2): 185-190
Category:
Original Paper
Overview
This study focuses on an assessment of cognitive functions in patients after cerebral artery aneurysm surgery.
The main research problem is to obtain a valid assessment pertaining to the decrease of cognitive performance. Authors discuss routine clinical techniques which are applied in day to day practice in the Czech Republic – comparison of Full-Scale IQ with a reference norm and difference between verbal and performance IQ. Eighty out of the 168 patients were neuropsychologically evaluated for 1.7 years after the operation.
The mean Full-Scale, Verbal and Performance IQ significantly decreased in comparison to the norm: 6.6 and 5 points, respectively. The mean difference between verbal and performance IQ was 0.5 points, p = 0.92.
The authors point out some disadvantages of using WAIS-R in this group of patients:
lack of difference between verbal and performance intellect, probably caused by diffuse brain injury; old norms as a probable reason for absence of cognitive deficit in some patients, insufficient information about premorbid intelligence level (pre-surgery testing not possible). The authors recommend using a premorbid intelligence test in patients after neurosurgery interventions.
Key words:
subarrachnoid hemorrhagie – cerebral aneurysm – cognitive deficit – premorbid intellect
Sources
1. King JT jr, Horowitz MB, Kassam AB, Yonas H, Roberts MS. The short form-12 and the measurement of health status in patients with cerebral aneurysms: performance, validity and reliability. J Neurosurg 2005; 102(3): 489–494.
2. Dombovy ML, Drew-Cates J, Serdans R. Recovery and rehabilitation following subarachnoid haemorrhage: part II long term follow up. Brain Inj 1998; 12(10): 887–894.
3. Hütter BO. Neuropsychological Sequelae of subarachnoid Hemorrhage. Vienna: Springer-Verlag 2000.
4. Jennett B, Bond M. Assessment of outcome after severe brain damage. Lancet 1975; 1(7905): 480–484.
5. Kreiter KT, Copeland D, Bernardini GL. Predictors of cognitive dysfunction after subarrachnoid hemorrhage. Stroke 2002; 33(1): 200–209.
6. Hütter B, Gilsbach J. Which neuropsychological deficits are hidden behind a good outcome (Glasgow = I) after aneurysmal subarachnoid hemorrhage? Neurosurgery 1993; 33(6): 999–1005.
7. Egge A, Waterloo K, Sjoholm H, Ingebrigsten T, Forsdahl S, Jacobsen EA et al. Outcome 1 year after aneurysmal subarachnoid hemorrhage: relation between cognitive performance and neuroimaging. Acta Neurol Scand 2005; 112(2): 76–80.
8. De Luca J. Cognitive dysfunction after aneurysm of the anterior communicating artery. J Clin Neuropsychol 1992; 14(6): 924–934.
9. Ogden JA, Mee EW, Henning M. A prospective study of impairment of cognition and memory and recovery after subarachnoid hemorrhage. Neurosurgery 1993; 33(4): 572–587.
10. Fertl E, Killer M, Eder H, Linzmayer L, Richling B, Auff E. Long-term functional effects of aneurysmal subarachnoid haemorrhage with special emphasis on the patient‘s view. Acta Neurochir (Wien) 199; 141(6): 571–577.
11. Berry E, Jones RAC, West CG, Brown JDK. Outcome of subarchnoid heamorrhage. An analysis of surgical variables, cognitive and emotional sequale related to SPECT scanning. Br J Neurosurgery 1997; 11(5): 378–387.
12. Mavaddat N, Sahakian BJ, Hutchinson PJ, Kirkpatrick PJ. Cognition following subarrachnoid hemorrhage from anterior communicating artery aneurysm: relation to timing of surgery. J Neurosurg 1999; 91(3): 402–407.
13. Tidswell P, Dias PS, Sagar HJ, Mayes AR, Battersby RD. Cognitive outcome after aneurysm rupture: relationship to aneurysm site and perioperative complications. Neurology 1995; 45(5): 875–882.
14. Wechsler D. WAIS-III, WMS-III. Technical Manual. San Antonio: The Psychological Corporation 1997.
15. Říčan P, Šebek M, Vágnerová M. Wechslerův inteligenční test pro dospělé. Bratislava: Psychodiagnostické a didaktické testy 1983.
16. Lezak MD, Howieson DB, Loring DV. Neuropsychological Assessment. New York: Oxford University Press 2004.
17. Bryson GJ. Differential rate of neuropsychological dysfunction in psychiatric disorders: comparison between the Halstead-Reitan and Luria-Nebraska batteries. Percept Mot Skills 1993; 76(1): 305–306.
18. Ballard C, Stephens S, Kenny RA, Tovee KM, O’Brien J. Profile of neuropsychological deficits in older stroke survivors without dementia. Dement Geriatr Cogn Disord 2003; 16(1): 52–56.
19. Sonesson B, Ljunggren B, Saveland H. Cognition and adjustment and early operation for ruptured aneurysm. Neurosurgery 1987; 21(3): 279–287.
20. Bornstein RA, Weir BKA, Petruk KC, Disney LB. Neuropsychological function in patients after subarachnoid hemorrhage. Neurosurgery 1987; 21(5): 651–654.
21. De Santis A, Laiacona M, Barbarotto R. Neuropsychological outcome of patients operated upon for an intracranial aneurysm. J Neurol Neurosurg Psychiatry 1989; 52(10): 1135–1140.
22. Kim DH, Haney CL, Ginhoven GV. Utility of outcome measures after treatment for intracranial aneurysms: a prospective trial involving 520 patients. Stroke 2005; 36(4): 792–796.
23. Al-Khindi T, Macdonald RL, Schweizer TA. Cognitive and functional outcome after aneurysmal subarachnoid hemorrhage. Stroke 2010; 41(8): e519–e536.
24. Proust F, Martinaud O, Gérardin E, Derrey S, Levèque S, Bioux S et al. Quality of life and brain damage after microsurgical clip occlusion or endovascular coil embolization for ruptured anterior communicating artery aneurysms: neuropsychological assessment. J Neurosurg 2009; 110(1): 19–29.
25. Vilkki J, Holst P, Ohman J, Servo A, Heiskanen O. Social outcome related to cognitive performance and computer tomographic findings after surgery for a ruptured intracranial aneurysm. Neurosurgery 1990; 26(4): 579–585.
26. Säveland H, Uski T, Sjöholm H, Sonnesson B, Brandt B. SPECT with technetium-99m-HMPAO in relation to late cognitive outcome for ruptured cerebral aneurysms. Acta Neurochir (Wien) 1996; 138(3): 301–307.
27. Flynn JR. What is intelligence? Beyond the Flynn Effect. Cambridge: Cambridge University Press 2007.
28. Krámská L. Možnosti měření premorbidního intelektu u pacientů po subarachnoidálním krvácení. Tvorba české verze zkoušky NART (dizertační práce). Praha: FF UK 2009.
29. Krámská L, Preiss M. Určování premorbidní úrovně – možnosti zkoušky čtení slov. Psychiatrie 2007; 11(1): 4–7.
30. Krámská L, Preiss M. Adaptation of the NART in Czech speakers – first experiences. J Int Neuropsychol Soc 2009; 15 (Suppl 2): 105.
31. Passier PE, Visser-Meily JM, Van Zandvoort MJ, Post MWM, Rinkel GJ, van Heugten C. Prevalence and Determinants of Cognitive Complaints after Aneurysmal Subarrachnoid Hemorrhage. Cerebrovasc Dis 2010; 29(6): 557–563.
32. Springer MV, Schmidt JM, Wartenberg KE, Frontera JA, Badjatia N, Mayer SA. Predictors of global cognitive impairment 1 year after subarachnoid hemorrhage. Neurosurgery 2009; 65(6): 1043–1051.
33. le Roux AA, Wallace MC. Outcome and Cost of Aneurysmal Subarachnoid Hemorrhage. Neurosurg Clin N Am 2010; 21(2): 235–246.
Labels
Paediatric neurology Neurosurgery NeurologyArticle was published in
Czech and Slovak Neurology and Neurosurgery
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