ABSTRACT
BACKGROUND: It is not completely clear whether there are differences in the evolution of the neuropsychological outcomes between the 2 intervention procedures (surgery and endovascular coiling) used in subarachnoid aneurysmatic hemorrhage. Some studies have investigated this topic but without completely controlling the effect of learning the tests. OBJECTIVE: To analyze our data using 2 different statistical procedures that attempt to solve this problem. METHODS: The sample consists of 70 patients who have suffered a subarachnoid hemorrhage: 40 treated by means of surgery and 30 by means of endovascular coiling. Two cognitive evaluations were performed at 4 and 12 months after the invention. Twenty-seven healthy subjects were also evaluated twice with a delay of 8 months. The data were analyzed using 2 different statistical procedures: one by Samra et al (2007) using z scores and the other by Crawford and Garthwaite (2007) using the regbuild.exe program. RESULTS: The results indicate there are no important differences between the 2 treatment groups in the evolution of the cognitive alterations. Despite an improvement in cognitive scores on repeat testing at 12 months, neither of the 2 treatment groups showed the same level of test-retest learning as healthy control subjects. CONCLUSION: The recovery of neuropsychological functions after a subarachnoid hemorrhage is similar with the 2 interventions. It is important to control the learning effect produced by the repeated administration of tests.
Subject(s)
Cognition Disorders/etiology , Endovascular Procedures/methods , Neurosurgery/methods , Recovery of Function/physiology , Subarachnoid Hemorrhage/complications , Subarachnoid Hemorrhage/surgery , Adult , Aged , Algorithms , Analysis of Variance , Cognition Disorders/therapy , Endovascular Procedures/instrumentation , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neuropsychological Tests , Treatment OutcomeABSTRACT
Very few studies have examined the neuropsychological differences between the two types of aneurysm treatment, and these studies come from different countries. The purpose of this study is to compare the neuropsychological differences between surgical treatment and endovascular treatment in a Spanish sample of patients who have experienced an aneurysmal subarachnoid hemorrhage. The sample is composed of three groups: 40 patients who underwent surgical intervention, 24 who were treated by means of coiling, and a group of 29 healthy participants. An extensive neuropsychological evaluation was performed. The results presented show that no neuropsychological differences were found between the two types of treatment for aneurysms and that the most affected function was memory. This result coincides with findings from other studies.
Subject(s)
Intracranial Aneurysm/physiopathology , Intracranial Aneurysm/psychology , Neuropsychological Tests , Adult , Aged , Analysis of Variance , Demography , Female , Humans , Intracranial Aneurysm/epidemiology , Intracranial Aneurysm/surgery , Male , Middle Aged , Neurosurgical Procedures/methods , Retrospective Studies , Spain/epidemiology , Vascular Surgical Procedures/methodsABSTRACT
BACKGROUND: According to previous studies, the quality of life is usually substantially altered in patients who have suffered a subarachnoid hemorrhage of an aneurysmal origin. Some studies have attempted to find out which factors predict the deterioration in quality of life. Our study will try to describe the quality of life of these patients and discover which variables may predict it in each of its dimensions. METHODS: The participants were 70 patients with aneurysmal subarachnoid hemorrhage between 15 and 85 years of age. The instrument used to measure the quality of life is the SF-36 with its eight dimensions. The predictor variables introduced into the multiple linear regressions are neurological condition on admission [World Federation of Neurological Surgeons (WFNS) scale and Hunt and Hess scale], extension of the hemorrhage (Fisher scale), sex, age, physical handicaps, and the Glasgow Outcome Scale (GOS) on release. RESULTS: The results showed that 42.9% of the patients had a deteriorated quality of life after 4 months, and that the most affected dimension was the Physical Role (60%). The two factors that predict quality of life are sex and physical handicaps. Other factors that intervene are the GOS on release and the WFNS. CONCLUSIONS: The patients who have experienced an aneurysmal subarachnoid hemorrhage show greater difficulty in performing daily activities, and they present more depression and anxiety. The absence of handicaps and being male are predictor factors for an unaffected quality of life.
Subject(s)
Cost of Illness , Health Status Indicators , Intracranial Aneurysm/complications , Quality of Life , Subarachnoid Hemorrhage/etiology , Activities of Daily Living , Adolescent , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Glasgow Outcome Scale , Humans , Intracranial Aneurysm/physiopathology , Intracranial Aneurysm/psychology , Linear Models , Male , Mental Health , Middle Aged , Recovery of Function , Risk Factors , Sex Factors , Subarachnoid Hemorrhage/physiopathology , Subarachnoid Hemorrhage/psychology , Surveys and Questionnaires , Time FactorsABSTRACT
We present a 24-year-old man with idiopathic segmental cervical and truncal dystonia of juvenile onset. His condition improved after unilateral stimulation of the internal globus pallidus ipsilateral to the contracting sternocleidomastoid muscle.