[Analysis and course of cognitive deficits after rupture of aneurysms of the anterior communicating artery]. / Analyse et évolution des déficits cognitifs après rupture des anévrysmes de l'artère communicante antérieure.

ABSTRACT

The aim of this study is to investigate general intellectual and memory performances at the secondary (3 weeks to 4.5 months) and late (10 to 16 months) stages following rupture of anterior communicating artery aneurysms (AACA). Twenty one patients presenting with selective lesion within frontal, or cingulate, callosal, caudate, basal forebrain areas were evaluated. At the secondary stage, the analysis of the general intellectual capacities revealed a drop of performance, prominent on performance IQ, which was more severe than the learning deficit. Specific cognitive evaluations revealed increase of the execution time, but performance was relatively preserved in the Stroop test, focused attention disorder was moderate the modified Wisconsin Card Sorting test was correctly performed in most cases; significant deficits of verbal short-term memory, long-term verbal and visuo-spatial learning, and access to semantic memory were observed. At the late stage, general intellectual performance improved, but did not reached the estimated prelesional level in most cases; specific cognitive disorders had most often disappeared. Most performances were best explained by the severity of lesions in the left cingulate cortex and corpus callosum area. These results show that the cognitive profile of AACA patients is different from classical descriptions of the "amnesic syndrome", and is also different at the secondary and late stages; this evolution has to be taken into account in studies describing cognitive deficits of such patients, or comparing them with others presenting with "annesic syndrome".