Evaluation of outcome after intracranial aneurysm surgery: The neuropsychiatric approach

被引:18
作者
Beristain, X
Gaviria, M
Dujovny, M
ElBary, THA
Stark, JL
Ausman, JI
机构
[1] UNIV ILLINOIS, COLL MED,INST NEUROPSYCHIAT,DEPT PSYCHIAT, NEUROPSYCHIAT SERV MC913, CHICAGO, IL 60612 USA
[2] UNIV ILLINOIS, DEPT PSYCHIAT, CHICAGO, IL 60612 USA
来源
SURGICAL NEUROLOGY | 1996年 / 45卷 / 05期
关键词
aneurysm; cognitive; evaluation; impairment; intracranial; neuropsychiatric;
D O I
10.1016/0090-3019(95)00454-8
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND With the reduction of mortality and gross neurologic morbidity of patients undergoing intracranial aneurysm surgery, the interest in outcome is shifting towards more subtle aspects such as cognitive deficits and psychosocial adjustment. METHODS We discuss two different ways of measuring outcome in a sample of 20 patients who had intracranial aneurysm surgery. Patients were evaluated at discharge using the Karnofsky Scale and the Glasgow Outcome Scale. Six months after discharge we conducted a neuropsychiatric evaluation including cognitive, behavioral, and mood status assessment. RESULTS Although 13 of our patients had a ''good recovery,'' 18 had some neuropsychiatric impairment. Comparing patients with ''good recovery'' with the remainder, patients with poorer outcomes tended to have a left pterional approach, a poorer ''drive,'' and language disorders (p < 0.05). There was no correlation between our cognitive, mood, and behavioral assessment and the results of the Karnofsky and Glasgow Outcome Scales (p > 0.05). CONCLUSIONS We conclude that neuropsychiatric deficits are common after intracranial aneurysm surgery and that for our study the Karnofsky Scale and Glasgow Outcome Scale were not sensitive enough to detect residual impairment. Therefore, it is important to develop brief tests and scales able to identify these problems and to complement the standard clinical neurologic examination.
引用
收藏
页码:422 / 428
页数:7
相关论文
共 33 条
[1]   BIOLOGICAL AND PSYCHOSOCIAL FACTORS IN RECOVERY FROM BRAIN-DAMAGE IN HUMANS [J].
BACHYRITA, P ;
BACHYRITA, EW .
CANADIAN JOURNAL OF PSYCHOLOGY-REVUE CANADIENNE DE PSYCHOLOGIE, 1990, 44 (02) :148-165
[2]   NEUROPSYCHOLOGICAL FOLLOW-UP OF PATIENTS OPERATED FOR ANEURYSMS OF THE MIDDLE CEREBRAL-ARTERY AND POSTERIOR COMMUNICATING ARTERY [J].
BARBAROTTO, R ;
DESANTIS, A ;
LAIACONA, M ;
BASSO, A ;
SPAGNOLI, D ;
CAPITANI, E .
CORTEX, 1989, 25 (02) :275-288
[3]  
Beck A.T., 1987, BECK DEPRESSION INVE
[4]   AN INVENTORY FOR MEASURING DEPRESSION [J].
BECK, AT ;
ERBAUGH, J ;
WARD, CH ;
MOCK, J ;
MENDELSOHN, M .
ARCHIVES OF GENERAL PSYCHIATRY, 1961, 4 (06) :561-&
[6]   TEMPORARY CLIPPING IN ANEURYSM SURGERY - TECHNIQUE AND RESULTS [J].
CHARBEL, FT ;
AUSMAN, JI ;
DIAZ, FG ;
MALIK, GM ;
DUJOVNY, M ;
SANDERS, J .
SURGICAL NEUROLOGY, 1991, 36 (02) :83-90
[7]   NEUROPSYCHOLOGICAL OUTCOME OF PATIENTS OPERATED UPON FOR AN INTRACRANIAL ANEURYSM - ANALYSIS OF GENERAL PROGNOSTIC FACTORS AND OF THE EFFECTS OF THE LOCATION OF THE ANEURYSM [J].
DESANTIS, A ;
LAIACONA, M ;
BARBAROTTO, R ;
BASSO, A ;
VILLANI, R ;
SPAGNOLI, D ;
CAPITANI, E .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1989, 52 (10) :1135-1140
[8]   A COMPARISON OF THE SYMPTOMS OF MEDICAL AND PSYCHIATRIC-PATIENTS MATCHED ON THE BECK DEPRESSION INVENTORY [J].
EMMONS, CA ;
FETTING, JH ;
ZONDERMAN, AB .
GENERAL HOSPITAL PSYCHIATRY, 1987, 9 (06) :398-404
[9]   RELATION OF CEREBRAL VASOSPASM TO SUBARACHNOID HEMORRHAGE VISUALIZED BY COMPUTERIZED TOMOGRAPHIC SCANNING [J].
FISHER, CM ;
KISTLER, JP ;
DAVIS, JM .
NEUROSURGERY, 1980, 6 (01) :1-9
[10]  
GAVIRIA M, 1994, AM NEUR ASS 6 ANN M