Joo Myung Sung, Park Dong Sun, Moon Chang Taek, Chun Young Il, Song Sang Woo, Roh Hong Gee
Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea.
Department of Radiology, Konkuk University Medical Center, Seoul, Korea.
J Cerebrovasc Endovasc Neurosurg. 2016 Sep;18(3):223-228. doi: 10.7461/jcen.2016.18.3.223. Epub 2016 Sep 30.
The gyrus rectus (GR) is known as a non-functional gyrus; hence, its resection is agreed to be a safe procedure frequently practiced to achieve a better surgical view during specific surgeries. This study aimed at comparing the cognitive outcomes following GR resection in patients who underwent surgery for ruptured anterior communicating artery (ACoA) aneurysms.
From 2012 to 2015, 39 patients underwent surgical clipping for ruptured ACoA aneurysms. Mini-mental state examinations (MMSE) were performed in 2 different periods. The statistical relationship between GR resection and MMSE results was evaluated, and further analysis of MMSE subgroup was performed.
Twenty-five out of the 39 patients (64.19%) underwent GR resection. Mean initial and final MMSE scores in the GR resection group were 16.3 ± 9.8 and 20.8 ± 7.3, respectively. In the non-resection group, the mean initial and final MMSE scores were 17.1 ± 8.6 and 21.9 ± 4.5, respectively. Neither group's scores showed a significant change. Subgroup analysis of initial MMSE showed a significant difference in memory recall and language ( = 0.02) but not in the final MMSE scores.
There was no significant relationship between the GR resection and cognitive outcomes in terms of total MMSE scores after surgery for ruptured ACoA aneurysm. However, subgroup analysis revealed a temporary negative effect of GR resection in the categories of language and memory recall. This study suggests that GR resection should be executed superficially, owing to its close anatomical relationship with the limbic system.
直回（GR）被认为是一个无功能的脑回；因此，人们一致认为切除直回是一种安全的手术操作，常在特定手术中用于获得更好的手术视野。本研究旨在比较破裂前交通动脉（ACoA）动脉瘤手术患者中切除直回后的认知结果。
2012年至2015年，39例患者接受了破裂ACoA动脉瘤的手术夹闭。在2个不同时期进行简易精神状态检查（MMSE）。评估直回切除与MMSE结果之间的统计学关系，并对MMSE亚组进行进一步分析。
39例患者中有25例（64.19%）接受了直回切除。直回切除组的平均初始和最终MMSE评分分别为16.3±9.8和20.8±7.3。在未切除组中，平均初始和最终MMSE评分分别为17.1±8.6和21.9±4.5。两组评分均未显示出显著变化。初始MMSE的亚组分析显示，在记忆回忆和语言方面存在显著差异（P=0.02），但最终MMSE评分无差异。
对于破裂ACoA动脉瘤手术后的总MMSE评分而言，直回切除与认知结果之间无显著关系。然而，亚组分析显示直回切除在语言和记忆回忆方面有暂时的负面影响。本研究表明，由于直回与边缘系统的解剖关系密切，应浅层次地进行直回切除。
