Table 1:
Patient | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
---|---|---|---|---|---|---|---|---|---|---|
Age (yr) (sex) | 52/M | 42/M | 39/M | 45/M | 54/M | 45/M | 69/M | 55/M | 39/M | 59/F |
Ruptured/unruptured | R | R | R | R | R | R | U | R | R | U |
CT gradea | 3 | 4 | 3 | 3 | 4 | 3 | NA | 4 | 4 | NA |
Treatment | Trap | Clip | Clip 2nd | Clip | Clip | Clip | Clip | Clip | Clip | Clip |
Months from treatmentb | 2 | 4 | 4b | 3 | 13 | 3 | 3 | 5 | 3 | 4 |
MMSEc | 24 | 25 | 26 | 28 | 25 | 28 | 26 | 24 | 23 | 27 |
IQd | 82 | 97 | 111 | 110 | 120 | 106 | 102 | 83 | 89 | 92 |
MQe | 58 | 59 | 68 | 92 | 92 | 87 | 86 | 64 | 68 | 67 |
IQ minus MQ | 24 | 38 | 43 | 18 | 28 | 19 | 16 | 19 | 21 | 25 |
Attention/concentration | 81 | 80 | 114 | 138 | 131 | 115 | 115 | 91 | 94 | 133 |
Delayed recall | <50 | <50 | <50 | <50 | 64 | 73 | 62 | <50 | <50 | <50 |
Note:—R indicates ruptured; U, unruptured; MMSE, Mini-Mental State Examination; IVH, intraventricular hemorrhage in the bilateral lateral ventricles; Trap, trapping; Clip, clipping; NA, not applied; WAIS-III, Wechsler Adult Intelligence Scale III; WMS-R, Wechsler Memory Scale-Revised.
CT grade, proposed by Claassen et al,39 classifies the severity of aneurysmal subarachnoid hemorrhage on CT scans at onset into 5 grades from 0 to 4, according to the appearance of both of SAH and intraventricular hemorrhage in the bilateral lateral ventricles: grade 0, no SAH or IVH; grade 1, minimal SAH, no IVH; grade 2, minimal SAH, with IVH; grade 3, thick SAH, no IVH; grade 4, thick SAH, with IVH. In this scaling, the definition of “thick” is “completely filling” ≥1 cistern or fissure. In 2 patients with unruptured aneurysm (patients 7 and 10), grading was not applied.
Months after second clipping.
MMSE, used to assess cognitive impairment (full score 30).40
IQ evaluated by the Wechsler Adult Intelligence Scale III.18
MQ, general memory quotient, attention/concentration quotient, and delayed recall quotient, evaluated by Wechsler Memory Scale-Revised.19 Each quotient has a mean of 100 in the normal population and an SD of 15. A substantial difference between IQ (by the WAIS-III) and MQ (by the WMS-R) scores indicates that the person with amnesia has a particular impairment in memory—but not in the “intelligence” per se.20