The Influence Of Communicating Artery Aneurysm Clipping Operation And Interventional Embolization On Cognitive Function

Spontaneous subarachnoid hemorrhage is a common cerebral vasculardisease which can lead to disability or even death. And the most common reasonfor spontaneous subarachnoid hemorrhage is attributed to intracranial aneurysmrupture. The incidence of aneurysm of the anterior communicating artery(AACA) accounts for about30%of intracranial aneurysms nowadays. Becauseof the particularity of position which is always located on both sides of theanterior cerebral artery, the main treatment methods are considered ascommunicating artery aneurysm clipping operation and interventionalembolization. Bleeding stimulation and treatment hemorrhage after the ruptureof anterior communicating artery aneurysm can directly affect patients withfrontal lobe function, and have further influence on the patients’ cognitivefunction. The concept of vascular cognitive impairment is first proposed in1993,it is considered as a series of syndromes from mild VCI（mVCI） to dementia that induced by cerebral vascular risk factors (such as hypertension,diabetes and hyperlipidemia) and pronounced (such as cerebral infarction andcerebral hemorrhage) or unobvious cerebrovascular diseases (such asleukoaraiosis and chronic cerebral ischemia). While, most of the researchesof vascular cognitive impairment in China and abroad are concentrated inischemic cerebrovascular diseases. Recently, Along with the vascular cognitiveimpairment gradually becoming a hotspot, more and more researches object tohemorrhagic cerebral vascular diseases, cognitive dysfunction induced by thetreatment of anterior communicating artery aneurysm has the certainrepresentation.Objective: Discussion on the influence of communicating artery aneurysmclipping operation and interventional embolization on cognitive function ofanterior communicating artery aneurysm patients.Method:①Analyzing the result of Mini-Mental State Examination(MMSE) of206patients with anterior communicating artery aneurysm,125cases with communicating artery aneurysm clipping operation and81cases withinterventional embolization,40cases of normal as contrast. Contrasting thedifference between MMSE scores of the patients group and the control group,and the difference between the incidences of cognitive dysfunction caused bytwo kinds of treatment.②According to the time interval between treatmentand MMSE, including six months, one year, two years and three years, allpatients are assigned into four groups, comparing the difference among fourgroups with the incidence of cognitive dysfunction.③Analyzing thepreoperative and postoperative score of51cases from the2011group,summarizing the preoperative cognitive status of anterior communicating arteryaneurysm patients, additionally, comparing the cognitive dysfunction variation from preoperative to postoperative between two groups of patients.Results:①In all of the206cases, the cognitive dysfunction incidence ofthe communicating artery aneurysm clipping operation group is49.60%,whilethe interventional embolization group is34.57%,they are proved to havestatistical significant difference by the Chi-square test(P<0.05). Both of twotherapies have influence on cognitive function in patients.②The cognitivedysfunction incidence of four groups that divided according to the time intervalbetween treatment and MMSE are62.75%、44.44%、26.67%and34.48%, theyare proved to have statistical significant difference by the Chi-squaretest(P<0.01).③The mean scores of preoperative and postoperative MMSE ofthe51cases from2011group are26.710.70and24.161.11,they are provedto have statistical significant difference by the t test(P<0.01).Conclusions: The anterior communicating artery aneurysm patients treatedby two kinds of treatment all possibly have the cognitive dysfunction, and theincidence of the communicating artery aneurysm clipping operation group ishigher than the interventional embolization group.②The incidence of thecognitive dysfunction declines with the increasing time interval betweentreatment and MMSE.③Patients with anterior communicating artery aneurysmhave already had the preoperative cognitive dysfunction, both of communicatingartery aneurysm clipping operation and interventional embolization have noameliorative effect on it. Instead, they could both increase the occurrence rateand aggravate the degree. Interventional embolization is better thancommunicating artery aneurysm clipping operation on the aspect of theoccurrence rate of cognitive dysfunction.