Ischemic complications of operations on intracranial aneurysms and their relationship with the dynamics of cognitive functions

2019 
Surgical treatment remains the only way to primary prevention of intracranial hemorrhage in patients with cerebral aneurysms. The implementation of such interventions is associated with the risk of the development of secondary cerebral circulation disorders. The effect of ischemic damage to cerebral structures on the state of mental functions and the quality of life of patients is currently not well understood. The interrelation of the formation of foci of cerebral infarction according to magnetic resonance imaging and the dynamics of the state of cognitive functions of patients undergoing surgery for unruptured cerebral aneurysms is considered. It has been established that «fresh» foci of ischemic damage are formed in a third of patients. Among patients operated on with intravascular access, brain infarction zones are formed in half of the patients. Endovascular interventions under balloon assistance are associated with a high risk of asymptomatic ischemic complications. When comparing the results of neuropsychological examination in patients with diagnosed foci of cerebral infarction and the group where the ischemic complications were absent, no significant differences were found. According to the neuropsychological examination, the results before and after the operation did not differ significantly in patients with infarction foci. Thus, after surgery for unruptured aneurysms, local foci of cerebral infarction are often detected. In most cases, these changes are not associated with the deterioration of the higher mental functions of patients and are asymptomatic.
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