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Brain Science Advances 2019, 5(1): 65-72 https://doi.org/10.26599/BSA.2019.9050006
Research Article | Open Access | Issue | Published: 19 December 2019

Effect of hemorrhagic cerebrospinal fluid drainage on cognitive function after intracranial aneurysm clipping

Show Author's Information Chaoqun Lin1,  Lukui Chen1,2( )
 School of Medicine, Southeast University, Nanjing 210009, Jiangsu, China
 Department of Neurosurgery, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China
Keywords:
cognitive function, Montreal Cognitive Assessment Scale, cerebrospinal fluid drainage
Cite this article:
Lin C, Chen L. Effect of hemorrhagic cerebrospinal fluid drainage on cognitive function after intracranial aneurysm clipping. Brain Science Advances, 2019, 5(1): 65-72. https://doi.org/10.26599/BSA.2019.9050006
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Abstract Full text About this article
Objective:

The effects of repeated lumbar puncture and continuous lumbar cistern drainage on the cognitive function of patients with aneurysmal subarachnoid hemorrhage were compared and analyzed.

Methods:

Retrospective analysis was performed on 59 patients with aneurysmal subarachnoid hemorrhage treated at our Neurosurgery Department between October 2017 and October 2018. According to the hemorrhagic cerebrospinal fluid drainage mode after aneurysm clipping, the patients were divided into the following two groups: the repeated lumbar puncture drainage (Group A, n = 28) and continuous lumbar cistern drainage (Group B, n = 31). Before and 1 month after surgery, the cognitive function of the patients was scored using the Montreal Cognitive Assessment Scale. Scores of 27~30 were defined as normal, and scores of < 27 as cognitive impairment.

Results:

The incidences of cognitive impairment were 46% (13/28) and 32% (10/31) for Groups A and B, respectively, before surgery, but the difference was not significant (P > 0.05). The incidences of cognitive impairment were 35% (10/28) and 12% (4/31) for Groups A and B, respectively, at 1 month after surgery, with significant difference (P < 0.05).

Conclusion:

Compared with repeated lumbar puncture, continuous lumbar cistern drainage for aneurysmal subarachnoid hemorrhage significantly reduced the incidence of cognitive impairment after aneurysm clipping.


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Abstract
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About this article

Effect of hemorrhagic cerebrospinal fluid drainage on cognitive function after intracranial aneurysm clipping

Show Author's information Chaoqun Lin1, Lukui Chen1,2( )
 School of Medicine, Southeast University, Nanjing 210009, Jiangsu, China
 Department of Neurosurgery, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China

Abstract

Objective:

The effects of repeated lumbar puncture and continuous lumbar cistern drainage on the cognitive function of patients with aneurysmal subarachnoid hemorrhage were compared and analyzed.

Methods:

Retrospective analysis was performed on 59 patients with aneurysmal subarachnoid hemorrhage treated at our Neurosurgery Department between October 2017 and October 2018. According to the hemorrhagic cerebrospinal fluid drainage mode after aneurysm clipping, the patients were divided into the following two groups: the repeated lumbar puncture drainage (Group A, n = 28) and continuous lumbar cistern drainage (Group B, n = 31). Before and 1 month after surgery, the cognitive function of the patients was scored using the Montreal Cognitive Assessment Scale. Scores of 27~30 were defined as normal, and scores of < 27 as cognitive impairment.

Results:

The incidences of cognitive impairment were 46% (13/28) and 32% (10/31) for Groups A and B, respectively, before surgery, but the difference was not significant (P > 0.05). The incidences of cognitive impairment were 35% (10/28) and 12% (4/31) for Groups A and B, respectively, at 1 month after surgery, with significant difference (P < 0.05).

Conclusion:

Compared with repeated lumbar puncture, continuous lumbar cistern drainage for aneurysmal subarachnoid hemorrhage significantly reduced the incidence of cognitive impairment after aneurysm clipping.

Keywords: cognitive function, Montreal Cognitive Assessment Scale, cerebrospinal fluid drainage

References(22)

[1]
JK Burkhardt, A Benet, MT Lawton. Management of small incidental intracranial aneurysms. Neurosurg Clin N Am. 2017, 28(3): 389-396.
Google Scholar
[2]
S Juvela, J Hernesniemi. Clinical manifestations and survival rates among patients with saccular intracranial aneurysms: population-based study in Olmsted County, Minnesota, 1965 to 1995. Neurosurgery. 2002, 50(5): 1167-1168; author reply 1168–9.
Google Scholar
[3]
M Dichgans, D Leys. Vascular cognitive impairment. Circ Res. 2017, 120(3): 573-591.
Google Scholar
[4]
JH Kim, D Chon. Association between cognitive impairment, vascular disease and all-cause mortality. J Nutr Health Aging. 2018, 22(7): 790-795.
Google Scholar
[5]
K Takata, HX Sheng, CO Borel, et al. Long-term cognitive dysfunction following experimental subarachnoid hemorrhage: new perspectives. Exp Neurol. 2008, 213(2): 336-344.
Google Scholar
[6]
ZS Nasreddine, NA Phillips, V Bédirian, et al. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005, 53(4): 695-699.
Google Scholar
[7]
GK Wong, SW Lam, A Wong, et al. Comparison of Montreal cognitive assessment and mini-mental state examination in evaluating cognitive domain deficit following aneurysmal subarachnoid haemorrhage. PLoS One. 2013, 8(4): e59946.
Google Scholar
[8]
G Chiti, L Pantoni. Use of Montreal cognitive assessment in patients with stroke. Stroke. 2014, 45(10): 3135-3140.
Google Scholar
[9]
GK Wong, K Ngai, SW Lam, et al. Validity of the Montreal cognitive assessment for traumatic brain injury patients with intracranial haemorrhage. Brain Inj. 2013, 27(4): 394-398.
Google Scholar
[10]
L Chen, CY Yu, XS Fu, et al. Using the Montreal cognitive assessment scale to screen for dementia in Chinese patients with Parkinson's disease. Shanghai Arch Psychiatry. 2013, 25(5): 296-305.
Google Scholar
[11]
E Sobreira, MA Pena-Pereira, AL Eckeli, et al. Screening of cognitive impairment in patients with Parkinson’s disease: diagnostic validity of the Brazilian versions of the Montreal cognitive assessment and the addenbrooke’s cognitive examination-revised. Arq Neuropsiquiatr. 2015, 73(11): 929-933.
Google Scholar
[12]
DS Brown, IH Bernstein, SM McClintock, et al. Use of the Montreal cognitive assessment and Alzheimer’s disease-8 as cognitive screening measures in Parkinson’s disease. Int J Geriatr Psychiatry. 2016, 31(3): 264-272.
Google Scholar
[13]
S Ohue, Y Oka, Y Kumon, et al. Importance of neuropsychological evaluation after surgery in patients with unruptured cerebral aneurysms. Surg Neurol. 2003, 59(4): 269-275; discussion 275–276.
Google Scholar
[14]
J Ravnik, B Starovasnik, S Sesok, et al. Long-term cognitive deficits in patients with good outcomes after aneurysmal subarachnoid hemorrhage from anterior communicating artery. Croat Med J. 2006, 47(2): 253-263.
Google Scholar
[15]
D Frazer, A Ahuja, L Watkins, et al. Coiling versus clipping for the treatment of aneurysmal subarachnoid hemorrhage: a longitudinal investigation into cognitive outcome. Neurosurgery. 2007, 60(3): 434-441; discussion 441–442.
Google Scholar
[16]
T Haug, A Sorteberg, W Sorteberg, et al. Surgical repair of unruptured and ruptured middle cerebral artery aneurysms: impact on cognitive functioning and health-related quality of life. Neurosurgery. 2009, 64(3): 412-420; discussion 421–422.
Google Scholar
[17]
Y Otawara, K Ogasawara, A Ogawa, et al. Cognitive function before and after surgery in patients with unruptured intracranial aneurysm. Stroke. 2005, 36(1): 142-143.
Google Scholar
[18]
JA Ogden, T Utley, EW Mee. Neurological and psychosocial outcome 4 to 7 years after subarachnoid hemorrhage. Neurosurgery. 1997, 41(1): 25-34.
Google Scholar
[19]
GK Wong, SW Lam, A Wong, et al. Early cognitive domain deficits in patients with aneurysmal subarachnoid hemorrhage correlate with functional status. Acta Neurochir Suppl. 2016, 122: 129-132.
Google Scholar
[20]
G Vourc’h. Continuous cerebrospinal fluid drainage by indwelling spinal catheter. Br J Anaesth. 1963, 35: 118-120.
Google Scholar
[21]
T Al-Khindi, RL Macdonald, TA Schweizer. Cognitive and functional outcome after aneurysmal subarachnoid hemorrhage. Stroke. 2010, 41(8): e519-e536.
Google Scholar
[22]
E Dagnew, HR van Loveren, JM Tew Jr. Acute foramen magnum syndrome caused by an acquired Chiari malformation after lumbar drainage of cerebrospinal fluid: report of three cases. Neurosurgery. 2002, 51(3): 823-828; discussion 828–829.
Google Scholar
Publication history
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Publication history

Received: 21 February 2019
Revised: 03 March 2019
Accepted: 19 March 2019
Published: 19 December 2019
Issue date: March 2019

Copyright

© The authors 2019

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 81671819).

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