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  • 1
    Electronic Resource
    Electronic Resource
    Cognitive deficits after rupture and early repair of anterior communicating artery aneurysms (1992)
    Springer
    Acta neurochirurgica 116 (1992), S. 6-13 
    Details
    ISSN: 0942-0940
    Keywords: Cognitive deficits ; anterior communicating artery ; ruptured aneurysm ; early operation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a retrospective follow-up study covering a time period of four years 18 patients operated upon early for an aneurysm of the anterior communicating artery (ACoA) and a control group of 21 patients with aneurysmal subarachnoid haemorrhage (SAH) from other sources than ACoA aneurysm and 9 patients with SAH of nonaneurysmal origin were subjected to neuropsychological examination. Both groups were comparable in their neurological condition on admission and in the severity of bleeding seen on CT-scan. Testing included memory functions, concentration, logical and spatial thinking, a Stroop-test, an aphasia screening test and a complex choice reaction task. Patients with SAH of a ruptured ACoA aneurysm did not differ significantly from the control group in any of the tests used. But there was a trend for the ACoA patients to have more memory problems than the patients with SAH of other origins. On the other hand the patients in the control group with aneurysmal SAH of other locations and with non-aneurysmal SAH had not significantly more problems with concentration and aphasia than the patients with ruptured ACoA aneurysm. These results, which differ from the common opinion of frequent occurrence of memory deficits in ACoA aneurysms are interpreted as a consequence of the changes in improved pre-, intra- and postoperative management in modern neurosurgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01541247
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Is there a difference in cognitive deficits after aneurysmal subarachnoid haemorrhage and subarachnoid haemorrhage of unknown origin? (1994)
    Springer
    Acta neurochirurgica 127 (1994), S. 129-135 
    Details
    ISSN: 0942-0940
    Keywords: Subarachnoid haemorrhage ; unknown origin ; aneurysmal subarachnoid haemorrhage ; cognitive deficits
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a retrospective follow-up study 38 patients with aneurysmal subarachnoid haemorrhage (SAH) and 20 patients without an angiographically proven source of SAH were tested neuropsychologically one to five years after the acute event. All patients were operated on early within 72 hours if an aneursym was proven angiographically and all were treated with nimodipine. Both patient groups had comparable cognitive deficits in spite of the less severe SAH of non-aneurysmal origin. Only in two cognitive functions the groups differed significantly. The patients after non-aneurysmal SAH had a significantly lower mean in the IQ subtest similarities finding (p〈0.05), while the patients after aneurysmal SAH had a significantly lower mean in a test of visual cognition (p〈0.05). A more detailed analysis with clinically homogenous subgroups was additionally performed. The results showed in the subgroup with poor clinical grades that patients with aneurysmal SAH were significantly more disturbed in focal cognitive functions like short- and long-term memory and word-finding capacity, while patients with SAH of unknown origin scored significantly worse in a neuropsychological test related to attention, which can be regarded as a more diffuse cognitive function.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01808755
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Early neuropsychological sequelae of aneurysm surgery and subarachnoid haemorrhage (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 1370-1379 
    Details
    ISSN: 0942-0940
    Keywords: Neuropsychology ; early aneurysm surgery ; subarachnoid haemorrhage ; cognitive deficits
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to disclose the immediate cognitive sequelae of early aneurysm surgery and subarachnoid haemorrhage (SAH), a series of 28 patients was examined neuropsychologically one to 13 days (median 5 days) after surgery. Cognitive deficits emerged in short- and long-term memory, language and in different functions of attention. There was no effect of ACoA aneurysm location on neuropsychological test performance. No substantial effect of premature aneurysm rupture or surgical approach could be revealed. Temporary clipping of vessels was associated with significantly worse selective attention and phasic alertness (p 〈 0.05, respectively). Partial resection of the gyrus rectus led to a worse short-term memory (p = 0.02). In regression analyses, the duration of temporary clipping was associated with worse short-term memory (adjusted r2 = 0.68; p = 0.007) and decreased phasic alertness (adjusted r2 = 0.47; p = 0.035). The clinical state on admission (Hunt and Hess) predicted an impaired phasic alertness (adjusted r2 = 0.43; p = 0.004). It is concluded from the results, that certain procedures and events in aneurysm surgery can have neuropsychological effects. The present study is restricted by the small sample size. Therefore, a prospective study with a larger patient sample is required for further confirmation of the present findings.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411114
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Virtual Pointer Projection of the Central Sulcus to the Outside of the Skull Using Frameless Neuronavigation – Accuracy and Applications (2000)
    Springer
    Acta neurochirurgica 142 (2000), S. 1385-1390 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Accuracy central sulcus; cortical mapping; frameless neuronavigation; image guided surgery.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Background. The purpose of this prospective study was to localize the central sulcus by frameless neuronavigation and to project this anatomical structure to the outside of the skull on the skin. This method was analyzed in respect to its practicability, accuracy, and potential applications.  Method. In 27 patients investigated (28 unaffected hemispheres), the central sulcus was virtually projected to the outside of the skull using frameless neuronavigation and a virtual pointer elongation of 15 or 20 mm. The following parameters were measured on the scalp: 1. the distance between the bregma and the midline junction of the central sulcus, and 2. the angle between the central sulcus and the midline. These dada were compared with measurements based on the original axial MR images of these patients. Finally, a laboratory phantom study was designed in analogy to a patient's examination for estimation of the overall accuracy of the neuronavigation system in the experimental setup used in this study.  Findings. Virtual pointer projection of the central sulcus to the outside of the skull using frameless neuronavigation was found to be easily possible. The distance between the bregma and the midline junction of the central sulcus amounted to a mean of 55 mm on the left and 56 mm on the right. The angle between the central sulcus and the midline reached a mean of 63° on the left and 60° on the right. These data confirmed results of other studies with no frameless neuronavigation devices. The phantom study revealed a mean overall inaccuracy of 0.9 mm at a virtual pointer elongation of 15 mm. At a virtual pointer elongation of 20 mm, the mean overall inaccuracy of our study was 1.1 mm. These results correspond to the inaccuracy of frame based stereotaxy.  Interpretation. It is easily possible, valid, and reliable to virtually project the central sulcus to the outside of the skull with an acceptably low inaccuracy using frameless neuronavigation. This is important for research studies that correlate and integrate different functional imaging methods with the aid of frameless neuronavigation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010070009
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    Paper (German National Licenses)
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