NEUROPSYCHOLOGICAL SEQUELLAE AND LIFE QUALITY OF PATIENTS AFTER SURGICAL TREATMENT OF CEREBRAL ANEURYSMS

Objective. To estimate the life quality level, neuropsychological status and cognitive functions in patients with cerebral aneurysms in early and delayed period after surgical treatment.

Material and methods. 140 patients with cerebral aneurysms operated in Military State Academy were examined in early and delayed postoperative periods. The SF-36 questionary, was used for estimation of life quality, anxiety level — Hamilton Rating Scale, cognitive functions - Mini Mental State Examination, Montreal Cognitive Assessment and battery of tests for estimation of frontal dysfunction.

Results. The decrease of life quality was revealed according to all subscales of SF-36 questionary in patients suffered from hemorrhage as well as deterioration of emotional aspect of life quality in patients with unruptured cerebral aneurysms. The cognitive dysfunctions are observed in half of patients with ruptured aneurysms in delayed postoperative period. The postoperative cognitive dysfunctions in patients with unruptured aneurysms were fragility and were not seen in delayed postoperative period.

Conclusion. The decrease of life quality and development of neuropsychological deficit are the often consequences of aneurysmal subarachnoid hemorrhage and surgical treatment of cerebral aneurysms in patients with good neurological outcomes with more expressed negative effect on these aspects after open surgery comparing with endovascular treatment.

1. Ayling O. et al. Operative complications and differences in outcome after clipping and coiling of ruptured intracranial aneurysms. J Neurosurg 2015; 123(3): 621-628.

2. Cedzich C. et al., Neurological and psychosocial outcome after subarachnoid haemorrhage, and the hunt and hess scale as a predictor of clinical outcome. Zentralbl Neurochir 2005; 66(3): 112-118.

3. Deane M. et al. The value of the Short Form 36 score in the outcome assessment of subarachnoid haemorrhage. Br J Neurosurg 1996; 10(2): 187-191.

4. Frazer D., Ahuja A., Watkins L. Coiling versus clipping for the treatment of aneurysmal subarachnoid hemorrhage: a longitudinal investigation into cognitive outcome. Neurosurgery 2007;60: 434-442.

5. Gilsbach J., Early aneurysm surgery: a 7 year clinical practice report. J Gilsbach. Acta Neurochir (Wien) 1988; 90(3): 91102.

6. Hedlund M. et al. Coping strategies, health-related quality of life and psychiatric history in patients with aneurysmal subarachnoid haemorrhage. Acta Neurochir 2010;152(8): 13751382.

7. Katati, M.J. et al. Description of Quality of Life and Its Predictors in Patients with Aneurysmal Subarachnoid Hemorrhage. Cerebrovascular Diseases 2007; 24(1): 66-73.

8. Naidech A. et al. Dichotomous “Good Outcome” Indicates Mobility More Than Cognitive or Social Quality of Life. Crit Care Med 2015; 43(8): 1654-1659.

9. Preiss M. et al. Quality of Life 1 Year after Aneurysmal Subarachnoid Hemorrhage in Good Outcome Patients Treated by Clipping or Coiling. J Neurol Surg A Cent Eur Neurosurg 2012; 73(04): 217-223.

10. Ronne-Engstrom E. et al. Health-related quality of life at median 12 months after aneurysmal subarachnoid hemorrhage, measured with EuroQoL-5D. Acta Neurochir (Wien) 2013;155(4): 587-593.

11. Schwyzer L. et al. Quality of life and outcome after treatment of ruptured cerebral aneurysms: results of a single center in Switzerland. Acta Neurochir Suppl 2015; 62(1): 197-201.

12. Skott R.B. et al. Improved Cognitive Outcomes With Endovascular Coiling of Ruptured Intracranial Aneurysms. Stroke 2010; 41(8): 1743-1747.

13. Taufique Z. et al. Predictors of Poor Quality of Life 1 Year After Subarachnoid Hemorrhage. Neurosurgery 2015; 77(3): 539-543.

14. Visser-Meily J. et al. Long-term health-related quality of life after aneurysmal subarachnoid hemorrhage: relationship with psychological symptoms and personality characteristics. Stroke 2009;40(4):1526-1529.

15. Voytsekhovsky D. et al. Screening of estimate cognitive function by using standard neuropsychological scales. Vestnik rossiyskoy voenno-meditsinskoy akademii 2016; 53 (1):3742.

16. von Vogelsang A. et al. Health-related quality of life 10 years after intracranial aneurysm rupture: a retrospective cohort study using EQ-5D. Neurosurgery 2013;72(3): 397-405.

17. Zweifel-Zehnder A.E. et al. Call for uniform neuropsychological assessment after aneurismal subarachnoid hemorrhage: Swiss recommendations. Acta Neurochir 2015; 157(9): 1449-1458.