RESUMO
OBJECTIVE: To assess the language and verbal fluency performance in aneurismal SAH pre- and post-surgery in patients caused by an aneurysm of the anterior communicating artery (AcomA), left middle cerebral artery (L-MCA) and left posterior comunicating artery (L-PcomA). METHODS: Assessment in 79 patients with SAH, on two occasions: pre- and post surgical treatment. They were divided into three groups by the aneurysms' location. RESULTS: Deterioration is detected in the performance of all patients during the post-surgical period; L-MCA aneurysm patients displayed a reduction in verbal naming and fluency; L-PcomA patients deteriorated in the written language and fluency tasks. CONCLUSION: After the surgical procedure the patients decreased in various language tasks and these differences in performance being directly related to the location of the aneurysm.
Assuntos
Aneurisma Roto/complicações , Aneurisma Intracraniano/complicações , Transtornos da Linguagem/etiologia , Hemorragia Subaracnóidea/complicações , Aneurisma Roto/classificação , Aneurisma Roto/cirurgia , Feminino , Humanos , Aneurisma Intracraniano/classificação , Aneurisma Intracraniano/cirurgia , Transtornos da Linguagem/diagnóstico , Testes de Linguagem , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Hemorragia Subaracnóidea/cirurgiaRESUMO
INTRODUCTION: The main purpose of occluding a ruptured aneurysm is preventing rebleeding, which may be fatal. Microsurgical or endovascular treatments are the main approaches adopted to prevent new bleeding. Among patients presenting with aneurysmal subarachnoid hemorrhage, about 50% had permanent injuries. Cognitive changes are one of the main morbidities from that illness. The type of treatment for the aneurysm (clipping or coil embolization) can also contribute to the genesis of those complications. OBJECTIVE: Assessing language and verbal memory changes resulting from the aneurysmal lesion occlusion procedures, as well as establish which treatment offers less cognitive sequels. METHOD: This investigation was carried out in Hospital da Restauraão, Recife-PE, from May 2007 to November 2009. One hundred fifty-one patients were divided into two groups, surgical and endovascular, and had their language, fluency, and verbal memory functions tested at two time points, pre- and postoperation. The results of the initial assessment and of the one occurring after the treatment were compared, between both groups and to each other. RESULTS AND CONCLUSIONS: One hundred fifty-one patients were assessed, distributed as 122 surgical and 29 coil embolized. The performances in both groups did not differ in the initial assessment. However, endovascular treatment does not show additional cognitive impairment and had a better performance in language and verbal memory, compared with patients submitted to surgical treatment in an early postoperative period.
Assuntos
Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/terapia , Embolização Terapêutica , Microcirurgia , Complicações Pós-Operatórias/etiologia , Hemorragia Subaracnóidea/diagnóstico , Hemorragia Subaracnóidea/terapia , Instrumentos Cirúrgicos , Angiografia Digital , Angiografia Cerebral , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Testes NeuropsicológicosRESUMO
OBJECTIVE: To detect changes in speech, verbal fluency, and memory in patients with subarachnoid hemorrhage (SAH) caused by ruptured aneurysms and to analyze the results before surgical or embolization procedure. METHODS: During the period May 2007 to November 2009, 193 patients with anterior aneurysmal SAH admitted to the Department of Neurosurgery, Hospital da Restauração, Recife, Brazil, were tested for speech, verbal fluency, and memory disturbances after the first week of bleeding and compared with a control group with similar demographics. RESULTS: Patients with aneurysmal SAH differed significantly from the control group in language, verbal fluency, and memory functions before clipping or coiling procedures. There were differences in cognitive performance between patients with different aneurysm sites. CONCLUSIONS: It was possible to characterize the cognitive impairments of each area affected early on in the preoperative period, confirming the assumptions that the aneurysm site could be a determining factor of cognitive impairment.