AI Article Synopsis

  • The study aimed to assess how deep white matter hyperintensities (DWMHs) affect cognitive function in patients undergoing surgery for unruptured intracranial aneurysms (UIAs), using MRI scans and the WAIS-R IQ test.
  • Out of 106 patients, the severity of DWMHs was categorized using the Fazekas scale, showing that more severe hyperintensities correlated with a higher percentage of patients experiencing cognitive decline post-surgery.
  • The findings indicated that patients with moderate to severe DWMHs had a significantly higher risk of postoperative cognitive dysfunction, suggesting that these abnormalities in brain imaging serve as important prognostic factors.

Article Abstract

To evaluate the effects on cognitive function of deep white matter hyperintensities (DWMHs) on magnetic resonance imaging (MRI) in patients treated surgically for unruptured intracranial aneurysms (UIAs). The subjects were 106 patients in whom a Wechsler adult intelligence scale-revised (WAIS-R) examination was performed 1 week before and 1 month after clipping surgery for asymptomatic UIAs. DWMH severity was evaluated on preoperative MR images by Fazekas scale, as follows: none (absence), mild (punctate foci), moderate (beginning confluence of foci), or severe (large confluent areas). A decrease of 7 or more points in intelligence quotient (IQ) postoperatively was considered deterioration. Fazekas score was none in 41 (none group), mild in 42 (mild group), moderate in 21, and severe in 2 patients (moderate/severe group). Patient characteristics, surgical factors, IQ change, and abnormal findings on postoperative MRI were compared among the groups. Although there was no statistically significant deterioration in IQ postoperatively in any group, the percentage of deteriorated patients was significantly higher in the moderate/severe group (34.8%) than in the other groups (4.9% in the none group, 7.1% in the mild group; p <0.01, p <0.05, respectively). Brain injury was observed more frequently on postoperative MR images in the moderate/severe group (17.4%) compared with the none group (2.4%; p = 0.052). The presence of moderate/severe DWMHs was an independent prognostic factor for postoperative cognitive dysfunction. In conclusion, the presence of moderate/severe DWMHs was a prognostic factor for postoperative cognitive dysfunction after surgery for UIAs.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905299PMC
http://dx.doi.org/10.2176/nmc.oa.2020-0290DOI Listing

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