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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1998 Jul;65(1):93–102. doi: 10.1136/jnnp.65.1.93

Neurobehavioural disturbances, rehabilitation outcome, and lesion site in patients after rupture and repair of anterior communicating artery aneurysm

S Bottger 1, M Prosiegel 1, H Steiger 1, A Yassouridis 1
PMCID: PMC2170144  PMID: 9667568

Abstract

OBJECTIVE—To determine: (1) patterns of cognitive and psychiatric dysfunction; (2) those neurobehavioural parameters which mostly influence disability in activities of daily living (ADL) and handicap in occupational and psychosocial activities, and (3) underlying neuroanatomical pathology in patients after rupture and repair of anterior communicating artery (ACoA) aneurysm.
METHODS—30 patients were extensively examined by means of a comprehensive battery of neuropsychological tests, by rating of psychopathological symptoms, and by use of the functional independence measure (FIM), Glasgow outcome scale (GOS), and MRI.
RESULTS AND CONCLUSIONS—(1) Three main groups were characterised by primary impairment of memory, executive functions, or of attentional performance. Within these main groups, specific patterns were identified relating to extent of primary dysfunction and associated disorders. The variety of neuropsychological disturbances is in contradiction to the existence of an "ACoA syndrome" as an entity. (2) Rehabilitation outcome proved to be mostly associated with both memory and attentional performance. (3) In neuropathological terms, lesions of the medial septum and nucleus of the diagonal band of Broca (MS/ndbB) were closely associated with memory deficits and prefrontal lesions were associated with attentional, executive, and psychopathological dysfunctions. At the same time, bilateral lesions were associated with severe disturbances. The type and severity of the above mentioned deficits were independent of the side of lesion in unilateral cases, of rectus gyrus resection, and of the Hunt and Hess grading system.



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Selected References

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  1. Alexander M. P., Freedman M. Amnesia after anterior communicating artery aneurysm rupture. Neurology. 1984 Jun;34(6):752–757. doi: 10.1212/wnl.34.6.752. [DOI] [PubMed] [Google Scholar]
  2. Bondi M. W., Kaszniak A. W., Rapcsak S. Z., Butters M. A. Implicit and explicit memory following anterior communicating artery aneurysm rupture. Brain Cogn. 1993 Jul;22(2):213–229. doi: 10.1006/brcg.1993.1035. [DOI] [PubMed] [Google Scholar]
  3. Damasio A. R., Graff-Radford N. R., Eslinger P. J., Damasio H., Kassell N. Amnesia following basal forebrain lesions. Arch Neurol. 1985 Mar;42(3):263–271. doi: 10.1001/archneur.1985.04060030081013. [DOI] [PubMed] [Google Scholar]
  4. DeLuca J. Cognitive dysfunction after aneurysm of the anterior communicating artery. J Clin Exp Neuropsychol. 1992 Nov;14(6):924–934. doi: 10.1080/01688639208402544. [DOI] [PubMed] [Google Scholar]
  5. DeLuca J. Predicting neurobehavioral patterns following anterior communicating artery aneurysm. Cortex. 1993 Dec;29(4):639–647. doi: 10.1016/s0010-9452(13)80287-0. [DOI] [PubMed] [Google Scholar]
  6. Hartje W., Rixecker H. Der Recurring-Figures-Test von Kimura. Normierung an einer deutschen Stichprobe. Nervenarzt. 1978 Jun;49(6):354–356. [PubMed] [Google Scholar]
  7. Horikoshi T., Nukui H., Mitsuka S., Kaneko M. Partial resection of the gyrus rectus in pterional approach to anterior communicating artery aneurysms. Neurol Med Chir (Tokyo) 1992 Mar;32(3):136–139. doi: 10.2176/nmc.32.136. [DOI] [PubMed] [Google Scholar]
  8. Hunt W. E., Hess R. M. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968 Jan;28(1):14–20. doi: 10.3171/jns.1968.28.1.0014. [DOI] [PubMed] [Google Scholar]
  9. Hütter B. O., Gilsbach J. M. Cognitive deficits after rupture and early repair of anterior communicating artery aneurysms. Acta Neurochir (Wien) 1992;116(1):6–13. doi: 10.1007/BF01541247. [DOI] [PubMed] [Google Scholar]
  10. Irle E., Wowra B., Kunert H. J., Hampl J., Kunze S. Memory disturbances following anterior communicating artery rupture. Ann Neurol. 1992 May;31(5):473–480. doi: 10.1002/ana.410310503. [DOI] [PubMed] [Google Scholar]
  11. Jennett B., Bond M. Assessment of outcome after severe brain damage. Lancet. 1975 Mar 1;1(7905):480–484. doi: 10.1016/s0140-6736(75)92830-5. [DOI] [PubMed] [Google Scholar]
  12. Klix F., Rautenstrauch-Goede K. Struktur- und Komponentenanalyse von Problemlösungsprozessen. Z Psychol Z Angew Psychol. 1967;174(3):167–193. [PubMed] [Google Scholar]
  13. Mayes A. R., Meudell P. R., MacDonald C. Disproportionate intentional spatial-memory impairments in amnesia. Neuropsychologia. 1991;29(8):771–784. doi: 10.1016/0028-3932(91)90071-f. [DOI] [PubMed] [Google Scholar]
  14. Mesulam M. M. Frontal cortex and behavior. Ann Neurol. 1986 Apr;19(4):320–325. doi: 10.1002/ana.410190403. [DOI] [PubMed] [Google Scholar]
  15. Mesulam M. M. Large-scale neurocognitive networks and distributed processing for attention, language, and memory. Ann Neurol. 1990 Nov;28(5):597–613. doi: 10.1002/ana.410280502. [DOI] [PubMed] [Google Scholar]
  16. Nelson H. E. A modified card sorting test sensitive to frontal lobe defects. Cortex. 1976 Dec;12(4):313–324. doi: 10.1016/s0010-9452(76)80035-4. [DOI] [PubMed] [Google Scholar]
  17. Paulesu E., Frith C. D., Frackowiak R. S. The neural correlates of the verbal component of working memory. Nature. 1993 Mar 25;362(6418):342–345. doi: 10.1038/362342a0. [DOI] [PubMed] [Google Scholar]
  18. Phillips S., Sangalang V., Sterns G. Basal forebrain infarction. A clinicopathologic correlation. Arch Neurol. 1987 Nov;44(11):1134–1138. doi: 10.1001/archneur.1987.00520230024008. [DOI] [PubMed] [Google Scholar]
  19. Rao S. M., Leo G. J., Haughton V. M., St Aubin-Faubert P., Bernardin L. Correlation of magnetic resonance imaging with neuropsychological testing in multiple sclerosis. Neurology. 1989 Feb;39(2 Pt 1):161–166. doi: 10.1212/wnl.39.2.161. [DOI] [PubMed] [Google Scholar]
  20. Richardson J. T. Cognitive performance following rupture and repair of intracranial aneurysm. Acta Neurol Scand. 1991 Feb;83(2):110–122. doi: 10.1111/j.1600-0404.1991.tb04659.x. [DOI] [PubMed] [Google Scholar]
  21. Shallice T. Specific impairments of planning. Philos Trans R Soc Lond B Biol Sci. 1982 Jun 25;298(1089):199–209. doi: 10.1098/rstb.1982.0082. [DOI] [PubMed] [Google Scholar]
  22. Shimamura A. P., Janowsky J. S., Squire L. R. Memory for the temporal order of events in patients with frontal lobe lesions and amnesic patients. Neuropsychologia. 1990;28(8):803–813. doi: 10.1016/0028-3932(90)90004-8. [DOI] [PubMed] [Google Scholar]
  23. Shoqeirat M. A., Mayes A. R. Disproportionate incidental spatial-memory and recall deficits in amnesia. Neuropsychologia. 1991;29(8):749–769. doi: 10.1016/0028-3932(91)90070-o. [DOI] [PubMed] [Google Scholar]
  24. Smith M. L., Milner B. The role of the right hippocampus in the recall of spatial location. Neuropsychologia. 1981;19(6):781–793. doi: 10.1016/0028-3932(81)90090-7. [DOI] [PubMed] [Google Scholar]
  25. Steiger H. J., Ilmberger J. Keeping in mind the mind: mental functions, networks and neurosurgery. Acta Neurochir (Wien) 1996;138(8):898–906. doi: 10.1007/BF01411276. [DOI] [PubMed] [Google Scholar]
  26. Stenhouse L. M., Knight R. G., Longmore B. E., Bishara S. N. Long-term cognitive deficits in patients after surgery on aneurysms of the anterior communicating artery. J Neurol Neurosurg Psychiatry. 1991 Oct;54(10):909–914. doi: 10.1136/jnnp.54.10.909. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Talland G. A., Sweet W. H., Ballantine H. T., Jr Amnesic syndrome with anterior communicating artery aneurysm. J Nerv Ment Dis. 1967 Sep;145(3):179–192. doi: 10.1097/00005053-196709000-00001. [DOI] [PubMed] [Google Scholar]
  28. Van der Linden M., Bruyer R., Roland J., Schils J. P. Proactive interference in patients with amnesia resulting from anterior communicating artery aneurysm. J Clin Exp Neuropsychol. 1993 Jul;15(4):525–536. doi: 10.1080/01688639308402576. [DOI] [PubMed] [Google Scholar]
  29. Van der Linden M., Bruyer R. Troubles de la mémoire et signes de dysfonctionnement frontal chez vingt-neuf patients opérés d'un anévrysme de l'artère communicante antérieure. Acta Neurol Belg. 1992;92(5):255–277. [PubMed] [Google Scholar]
  30. Volpe B. T., Hirst W. Amnesia following the rupture and repair of an anterior communicating artery aneurysm. J Neurol Neurosurg Psychiatry. 1983 Aug;46(8):704–709. doi: 10.1136/jnnp.46.8.704. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. von Cramon D. Y., Schuri U. The septo-hippocampal pathways and their relevance to human memory: a case report. Cortex. 1992 Sep;28(3):411–422. doi: 10.1016/s0010-9452(13)80151-7. [DOI] [PubMed] [Google Scholar]

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