gms | German Medical Science

Objective: Until now, only few studies have addressed the effect of unruptured intracranial aneurysm (UIA) treatment on cognitive function. Neuropsychological assessment after UIA treatment is underreported and prospective trials have repeatedly been demanded. In 2014, we conducted a prospective and controlled study to evaluate detectable differences of cognitive processing due to the treatment modality in anterior circulation UIA.

Method: 30 patients (study group with UIA n=20, control group n=10) have been enrolled until September 2015. 10 patients received endovascular aneurysm occlusion (EV), 10 patients were treated microsurgically (MS) and 10 patients with surgically approached lumbar disc herniation (LD) served as control. In all patients, extended standardized neuropsychological assessment was performed preoperatively and after 6 weeks postoperatively. Testing included verbal, visual, and visuospatial memory, psychomotor functioning, executive functioning, verbal fluency and cognitive flexibility. We statistically evaluated intra- and intergroup changes.

Results: The overall neuropsychological performance was not significantly impaired postinterventionally/postoperatively. However, postoperatively, the MC group performed significantly worse in cognitive processing speed and in executive functioning (p=0.011 and p=0.038, resp.). Verbal memory and verbal fluency trended toward posttreatment impairment in the MC group compared to the control group (p = 0.06 and p=0.083, resp.).

Conclusions: The preliminary data revealed that the treatment modality for UIA of the anterior circulation did not affect the overall neuropsychological function but resulted in impairment of executive processing in surgically treated UIA patients in the short-term.