Alteraciones neuropsicológicas en pacientes con aneurismas cerebrales: tratamiento quirúrgico versus tratamiento endovascular
Neuropsychological impairment in patients with intracranial aneurysms: surgical versus endovascular treatment
M.J. Katati
, J.M. Martín, E. Saura, A. Jorques, V. Arjona
Servicios de Neurocirugía. Hospital Universitario Virgen de las Nieves. Granada
C. Orozco-Giménez*, R. Vilar*, M. Meersmans*, M. Pérez-García*, P. Alcázar**, F. Guerrero***, F. Escamilla****, A. Mínguez****, G. Olivares****
* Departamento de Psicología. Universidad de Granada. Hospital Universitario Virgen de las Nieves. Granada
** Servicios de Neurorradiología. Hospital Universitario Virgen de las Nieves. Granada
*** Servicios de Cuidados Intensivos. Hospital Universitario Virgen de las Nieves. Granada
**** Servicios de Neurología. Hospital Universitario Virgen de las Nieves. Granada
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Granada" "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0015" ] 2 => array:3 [ "entidad" => "Servicios de Cuidados Intensivos. Hospital Universitario Virgen de las Nieves. Granada" "etiqueta" => "<span class="elsevierStyleSup">***</span>" "identificador" => "aff0020" ] 3 => array:3 [ "entidad" => "Servicios de Neurología. Hospital Universitario Virgen de las Nieves. Granada" "etiqueta" => "****" "identificador" => "aff0025" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Neuropsychological impairment in patients with intracranial aneurysms: surgical versus endovascular treatment" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-02-09" "fechaAceptado" => "2004-06-22" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec159148" "palabras" => array:5 [ 0 => "Aneurisma cerebral" 1 => "Embolización" 2 => "Cirugía" 3 => "Cognición" 4 => "Neuropsicología" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec159149" "palabras" => array:5 [ 0 => "Irntracranial aneurysms" 1 => "Endovascular embolization" 2 => "Surgery" 3 => "Cognition" 4 => "Neuropsychology" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir el rendimiento neuropsicológico de pacientes con aneurismas cerebrales que han sido tratados mediante cirugía o embolización, y determinar la existencia de diferencias en función de la modalidad de tratamiento.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Serie clínica compuesta por 93 pacientes voluntarios, con aneurismas cerebrales, tratados mediante cirugía (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>56) o embolización (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>37). A ambos grupos se les realizó una evaluación neuropsicológica retrospectiva, al menos un año después de realizar el tratamiento.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En ambos grupos se encontraron pacientes con déficit neuropsicológicos. En el grupo de pacientes tratados quirúrgicamente el porcentaje de pacientes sin ninguna afectación neuropsicológica es del 35.7%, mientras que en el grupo de pacientes embolizados este porcentaje asciende al 43.2%. Los análisis muestran una ejecución mejor en el grupo de tratamiento endovascular, respecto al quirúrgico, sólo en memoria visual y en el recuerdo con claves de la memoria verbal.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Años después del tratamiento, un importante porcentaje de pacientes presenta alteraciones neuropsicológicas. El tratamiento endovascular se asocia con un mejor rendimiento en memoria visual y en el recuerdo con claves de la memoria verbal, aunque explica un porcentaje muy escaso de la varianza. Por lo tanto, en la explicación del deterioro neuropsicológico parece más importante el propio efecto de la hemorragia que la modalidad de intervención.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To describe the neuropsychological status of patients with intracranial aneurysms and to compare the cognitive status of patients with intracranial aneurysm treated by surgical or endovascular mehtods.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Ninety-three cases with intracranial aneurysms treated with surgery (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>56) or embolization (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>37) were included. A neuropsychological assessment was applied to both groups retrospectively, at least one year after treatment.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Neuropsychological impairment was found in both groups. 35.7% of the patients treated with surgery and 43.2%, of those treated with embolization did not show any cognitive impairment. Visual Memory and Cued Recall of verbal information are better in patients treated by embolization.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Our results show that a large proportion of patients with intracranial aneurysms have cognitive impairment after treatment. Endovascular management may cause less impairment in visual and verbal memory. However, bleeding may be the most important factor to explain these cognitive impairments.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Orozco-Giménez, C.; Katati, M.J.; Vilar, R.; Meersmans, M.; Pérez-García, M.; Martín, J.M.; Alcázar, P.; Guerrero, F.; Escamillo, F.; Mínguez, A.; Olivares, G.; Saura, E.; Jorques, A.; Arjona, V.: Alteraciones neuropsicológicas en pacientes con aneurismas cerebrales: tratamiento quirúrgico versus tratamiento endovascular. Neurocirugía 2006; 17: 34–45.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcome of subarachnoid haemorrhage. 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| año/Mes | Html | Total | |
|---|---|---|---|
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