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颅内动脉瘤治疗后急性期认知功能的临床影响因素:一项横断面研究

Clinical Factors Contributing to Cognitive Function in the Acute Stage after Treatment of Intracranial Aneurysms: A Cross-Sectional Study.

作者信息

Kim Yeo Jin, Lee Sang-Hwa, Jeon Jin Pyeong, Choi Hui-Chul, Choi Hyuk Jai

机构信息

Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si 24253, Korea.

Department of Neurosurgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si 24253, Korea.

出版信息

J Clin Med. 2022 Aug 28;11(17):5053. doi: 10.3390/jcm11175053.

Abstract

Background: The factors affecting cognitive function after treatment of subarachnoid haemorrhage (SAH) can be categorised into aneurysmal factors, procedural factors, and complications. The aim of this study was to investigate which of these factors has greater influence on the cognitive function. Methods: We retrospectively identified 14 patients with unruptured intracranial aneurysms (UIAs) and 34 patients with SAH with mild symptoms at disease onset (Hunt and Hess grade: >3). All patients underwent neuropsychological tests within 35 days of discharge from hospitalisation for treatment. The relationship between the clinical factors and each neuropsychological test score was evaluated using multiple linear regression analysis after controlling for age and years of education. Results: Patients with UIA showed greater cognitive impairment in visual memory and the frontal/executive domains. Hypertension was associated with cognitive impairment. Patients with SAH showed greater cognitive impairment in the visuospatial, verbal memory, and frontal/executive domains. The dome-to-neck ratio, aneurysms located in the posterior circulation, microsurgical clipping, procedure time, anaesthesia duration, and complications were associated with cognitive impairment. Conclusions: Underlying diseases, procedural factors, and complications contributed to cognitive impairment after treatment of intracranial aneurysms. Since the effect of each factor on each cognitive domain was slightly different, a more in-depth study of these effects is needed.

摘要

背景

蛛网膜下腔出血(SAH)治疗后影响认知功能的因素可分为动脉瘤因素、手术因素和并发症。本研究的目的是调查这些因素中哪一个对认知功能有更大影响。方法:我们回顾性地确定了14例未破裂颅内动脉瘤(UIA)患者和34例发病时症状较轻的SAH患者(Hunt和Hess分级:>3级)。所有患者在因治疗住院出院后35天内接受神经心理学测试。在控制年龄和受教育年限后,使用多元线性回归分析评估临床因素与每项神经心理学测试分数之间的关系。结果:UIA患者在视觉记忆和额叶/执行领域表现出更大的认知障碍。高血压与认知障碍有关。SAH患者在视觉空间、言语记忆和额叶/执行领域表现出更大的认知障碍。瘤颈比、位于后循环的动脉瘤、显微手术夹闭、手术时间、麻醉持续时间和并发症与认知障碍有关。结论:基础疾病、手术因素和并发症导致颅内动脉瘤治疗后出现认知障碍。由于每个因素对每个认知领域的影响略有不同,因此需要对这些影响进行更深入的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46f9/9457194/5b8eb9540c46/jcm-11-05053-g001.jpg

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