Journal article
Postoperative cognitive dysfunction after endovascular treatments for unruptured intracranial aneurysms: A pilot study
Interventional neuroradiology, Vol.28(4), pp.439-443
08/2022
DOI: 10.1177/15910199211039917
PMCID: PMC9326860
PMID: 34516320
Abstract
Objective Post operative cognitive dysfunction (POCD) has been widely observed after major surgery, particularly in elderly patients with general anesthesia (GA). However, a specific unanswered question is whether different approaches to anesthetic managements are associated with different cognitive outcomes after endovascular treatments for unruptured intracranial aneurysms (UIAs). The purpose of this study is to assess the correlation of POCD with GA versus monitored anesthesia care (MAC). Methods We performed a pragmatic, prospective study to assess the association between different anesthetic approaches and POCD. We compared the pre- and post-procedural Montreal Cognitive Assessment (MoCA) scores in patients with normal cognition who underwent treatments of UIAs with various endovascular methods, using either GA or MAC. Results A total of 23 patients with UIAs were enrolled in the study. Seven (30.4%) and sixteen (69.6%) UIAs were treated without perioperative complications under GA or MAC, respectively. There was a significant decline in the post-procedural MoCA score under GA (mean difference = 1.14; 95% confidence interval = [0.42–1.87], P < 0.01). By contrast, there was no significant difference of MoCA score between pre- and post-procedure under MAC (mean difference = 0.19; 95% confidence interval = [−0.29–0.67], P = 0.59). Conclusions Treating UIAs using MAC was associated with a decrease in POCD as compared to GA in patients undergoing endovascular treatments for UIAs with normal cognition. Larger randomized studies are needed to confirm these findings.
Details
- Title: Subtitle
- Postoperative cognitive dysfunction after endovascular treatments for unruptured intracranial aneurysms: A pilot study
- Creators
- Daizo Ishii - Department of Neurosurgery, University of Iowa Hospitals and Clinics, USAMario Zanaty - Department of Neurosurgery, University of Iowa Hospitals and Clinics, USAJorge A Roa - Department of Neurology, University of Iowa Hospitals and Clinics, USALuyuan Li - Department of Neurosurgery, University of Iowa Hospitals and Clinics, USAYongjun Lu - Department of Neurosurgery, University of Iowa Hospitals and Clinics, USALauren Allan - Department of Surgery, University of Iowa Hospitals and Clinics, USAEdgar A Samaniego - Department of Neurology, University of Iowa Hospitals and Clinics, USAJames C Torner - Department of Epidemiology, University of Iowa, USADaniel Tranel - Department of Neurology, University of Iowa Hospitals and Clinics, USA, Department of Psychological and Brain Sciences, University of Iowa, USADavid M Hasan - Department of Neurosurgery, University of Iowa Hospitals and Clinics, USA
- Resource Type
- Journal article
- Publication Details
- Interventional neuroradiology, Vol.28(4), pp.439-443
- DOI
- 10.1177/15910199211039917
- PMID
- 34516320
- PMCID
- PMC9326860
- NLM abbreviation
- Interv Neuroradiol
- ISSN
- 1591-0199
- eISSN
- 2385-2011
- Grant note
- DOI: 10.13039/501100008884, name: Nakatani Foundation for Advancement of Measuring Technologies in Biomedical Engineering
- Language
- English
- Electronic publication date
- 09/13/2021
- Date published
- 08/2022
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Critical Care; Stead Family Department of Pediatrics; Epidemiology; Psychological and Brain Sciences; Iowa Neuroscience Institute; Surgery; Injury Prevention Research Center; Neurosurgery; Otolaryngology
- Record Identifier
- 9984214814902771
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