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Visuospatial Changes After Clipping of Anterior Communicating Artery Aneurysms

Friday, May 3, 2024

    Presenting Author(s)

  • Leonardo de Barros Oliveira (he/him/his)

    Medical Student
    Department of Neurosurgery, State University of Ponta Grossa, Paraná, Brazil

    • Co-Author(s)

  • SB

    Savio Batista, n/a

    Medical Student
    Federal University of Rio de Janeiro
    Rio De Janeiro, Rio de Janeiro, Brazil

  • Raphael Bertani, MD

    Neurosurgeon
    Department of Neurosurgery, University of São Paulo
    São Paulo, SP, BR

  • CC

    Camila Cechi, n/a

    Neurosychologist
    University of São Paulo, United States

  • Marcio Yuri Ferreira, MD

    Research Collaborator
    Program in Global Surgery and Social Change - Harvard Medical School. Postgraduate Program in Translational Surgery of Federal University of São Paulo, Brazil

  • EF

    Eberval G. Figueiredo, MD, PhD

    Professor
    Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo
    Phoenix, Arizona, United States

  • IM

    Ibero Martin, n/a

    Doctor
    Department of Neurosurgery, University of São Paulo, São Paulo, São Paulo, Brazil., Brazil

  • AM

    Ana Paula Micieli, n/a

    Psychologist
    Department of Neurosurgery, University of São Paulo, São Paulo, São Paulo, Brazil., United States

  • GS

    Guilherme Melo M. Silva, n/a

    Medical Student
    Federal University of Rio de Janeiro, Brazil

  • JV

    Jessica Vismara, n/a

    Doctor
    Department of Neurosurgery, University of São Paulo, São Paulo, São Paulo, Brazil., United States

Introduction: A series of symptoms are commonly seen after anterior communicating artery (ACoA) aneurysm clipping. Previous studies designated it as ACoA syndrome, a condition in which symptoms like amnesia, confabulation, and personality changes are observed. The present study investigates visuospatial impairments associated with ACoA aneurysm rupture followed by subarachnoid hemorrhage (SAH) and clipping procedure.

Methods: A total 31 patients who underwent surgical clipping of the ACoA after SAH were evaluated prospectively at three, six, and twelve months after the surgery. Hooper Visual Organization test (HVOT), Judgment of Line Orientation test (JLOT), and Stroop-I test were used to evaluate visual organization, visual orientation perception, and visual attention, respectively.

Results: Regarding the HVOT, the mean score observed in each observation was at three, six, and twelve months, respectively: 20.2 (SD ±4.4), 21.5 (SD ±4.7), and 20.9 (SD ±4.6). The JLOT, in turn, presented the following results at the same respective time frames: 19.0 (SD ±4.9); 19.7 (SD ± 4.3); 21.2 (SD ±4.7). Finally, for the Stroop-I test, a similar pattern was found: 18.35 (SD ±5.8); 18.00 (SD ±6); 17.00 (SD ±4.4). Of all aforementioned tests, only Stroop-I test scores did not follow a normal distribution.

Conclusion : Visuospatial and visuoperceptual abilities can also present impairments after SAH following ACoA aneurysm rupture and clipping, although it is commonly a mild symptom. Therefore, diffuse symptomatology may be seen, rather than the stricter ACoA syndrome described in the literature. Moreover, positive outcomes are expected twelve months after postoperatively.