{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T22:34:02Z","timestamp":1776724442360,"version":"3.51.2"},"reference-count":64,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,9]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> This study was conducted to define neuropsychological changes following operation for subarachnoid hemorrhage (SAH) caused by rupture of an anterior communicating artery (ACoA) aneurysm and to assess the influence of the timing of surgery to clip the aneurysm.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> Cognitive outcome was evaluated using the Cambridge Neuropsychological Test Automated Battery in patients with an ACoA aneurysm that had caused an SAH. Adult patients younger than 70 years of age who had achieved a favorable neurological outcome (Glasgow Outcome Scale scores of 4 or 5) were studied 6 to 24 months postsurgery. Patients were divided into early (Days 0\u20133) and late surgery groups (after Day 3) according to the timing of surgery after the ictus. Neuropsychological analysis was performed by reviewers who were blinded to the timing of surgery.<\/jats:p><jats:p content-type=\"fine-print\">Forty-seven patients whose mean age was 51.5 years were tested. They were compared with age- and intelligence quotient (IQ)\u2014matched controls by using premorbid IQ as estimated on the National Adult Reading Test. Patients showed deficiencies in several tasks of verbal fluency, pattern recognition, and spatial working memory; this profile of deficits was similar to that seen in patients who underwent temporal lobe excisions. However, there was no significant difference in cognitive performance between the early and late surgery groups.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> After open surgery for ruptured ACoA aneurysms, patients who have achieved a favorable neurological outcome still exhibit significant cognitive deficits, primarily in tests sensitive to temporal lobe dysfunction. However, early surgery does not carry a higher risk of neuropsychological disability.<\/jats:p>","DOI":"10.3171\/jns.1999.91.3.0402","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:21:15Z","timestamp":1242235275000},"page":"402-407","source":"Crossref","is-referenced-by-count":68,"title":["Cognition following subarachnoid hemorrhage from anterior communicating artery aneurysm: relation to timing of surgery"],"prefix":"10.3171","volume":"91","author":[{"given":"Nahal","family":"Mavaddat","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara J.","family":"Sahakian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J. A.","family":"Hutchinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J.","family":"Kirkpatrick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1212\/WNL.34.6.752","article-title":"Amnesia after anterior communicating artery aneurysm rupture.","volume":"34","author":"Alexander","year":"1984"},{"key":"b2","series-title":"Neuropsychologia","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/0028-3932(95)00133-6","article-title":"Neural systems engaged in planning: a PET study of the Tower of London task.","volume":"34","author":"Baker","year":"1996"},{"key":"b3","series-title":"Depression: Causes and Treatment.","author":"Beck","year":"1970"},{"key":"b4","series-title":"Multilingual Aphasia Examination.","author":"Benton","year":"1976"},{"key":"b5","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1001\/archneur.1985.04060030081013","article-title":"Amnesia following basal forebrain lesions.","volume":"42","author":"Damasio","year":"1985"},{"key":"b6","series-title":"Cortex","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1016\/S0010-9452(13)80287-0","article-title":"Predicting neurobehavioral patterns following anterior communicating artery aneurysm.","volume":"29","author":"Deluca","year":"1993"},{"key":"b7","series-title":"J Clin Exp Neuropsychol","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1080\/13803399508406586","article-title":"Aneurysm of the anterior communicating artery: a review of neuroanatomical and neuropsychological sequelae.","volume":"17","author":"Deluca","year":"1995"},{"key":"b8","series-title":"Cortex","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/S0010-9452(75)80026-8","article-title":"Verbal and non-verbal short-term memory impairment following hemispheric damage.","volume":"11","author":"De Renzi","year":"1975"},{"key":"b9","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.1136\/jnnp.52.10.1135","article-title":"Neuropsychological outcome of patients operated upon for an intracranial aneurysm: analysis of general prognostic factors and of the effects of the location of the aneurysm.","volume":"52","author":"Desantis","year":"1989"},{"key":"b10","series-title":"Med J Aust","doi-asserted-by":"publisher","first-page":"18","DOI":"10.5694\/j.1326-5377.1984.tb132661.x","article-title":"Surgery for cerebral aneurysms. An eight-year experience.","volume":"141","author":"Dorsch","year":"1984"},{"key":"b11","series-title":"Med J Aust","doi-asserted-by":"publisher","first-page":"183","DOI":"10.5694\/j.1326-5377.1989.tb136422.x","article-title":"Timing of surgery for cerebral aneurysms: a plea for early referral.","volume":"150","author":"Dorsch","year":"1989"},{"key":"b12","series-title":"Semin Neurol","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1055\/s-2008-1041568","article-title":"Behavioral disturbances associated with rupture of anterior communicating artery aneurysms.","volume":"4","author":"Eslinger","year":"1984"},{"key":"b13","series-title":"J Psychiatr Res","first-page":"189","article-title":"\u2018Mini-mental state\u2019. A practical method for grading the cognitive state of patients for the clinician.","volume":"12","author":"Folstein","year":"1975"},{"key":"b14","series-title":"J Exp Psychol","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1037\/h0059831","article-title":"A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem.","volume":"38","author":"Grant","year":"1948"},{"key":"b15","series-title":"J Neurol Neurosurg Psychiatry","first-page":"552","article-title":"A prospective audit of aneurysmal subarachnoid haemorrhage comparing early and late surgery.","volume":"61","author":"Hutchinson","year":"1996"},{"key":"b16","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1007\/BF01541247","article-title":"Cognitive deficits after rupture and early repair of anterior communicating artery aneurysms.","volume":"116","author":"H\u00fctter","year":"1992"},{"key":"b17","series-title":"Neurosurgery","first-page":"999","article-title":"Which neuropsychological deficits are hidden behind a good outcome (Glasgow=I) after aneurysmal subarachnoid hemorrhage?","volume":"33","author":"H\u00fctter","year":"1993"},{"key":"b18","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1080\/02688699550041106","article-title":"Quality of life and cognitive deficits after subarachnoid haemorrhage.","volume":"9","author":"H\u00fctter","year":"1995"},{"key":"b19","series-title":"Pharmacol Biochem Behav","first-page":"781","article-title":"Uncomplicated carotid endarterectomy is not associated with neuropsychological impairment.","volume":"56","author":"Iddon","year":"1996"},{"key":"b20","series-title":"Lancet","first-page":"480","article-title":"Assessment of outcome after severe brain damage. A practical scale.","volume":"1","author":"Jennett","year":"1975"},{"key":"b21","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"37","DOI":"10.3171\/jns.1990.73.1.0037","article-title":"The International Cooperative Study on the Timing of Aneurysm Surgery. Part 2: Surgical results.","volume":"73","author":"Kassell","year":"1990"},{"key":"b22","series-title":"Information Theory and Statistics.","author":"Kullbach","year":"1968"},{"key":"b23","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1097\/00006123-199605000-00006","article-title":"The incidence of surgical complications is similar in good and poor grade patients undergoing repair of ruptured anterior circulation aneurysms: a retrospective review of 355 patients.","volume":"38","author":"Le Roux","year":"1996"},{"key":"b24","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"673","DOI":"10.3171\/jns.1985.62.5.0673","article-title":"Cognitive impairment and adjustment in patients without neurological deficits after aneurysmal SAH and early operation.","volume":"62","author":"Ljunggren","year":"1985"},{"key":"b25","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1136\/jnnp.54.4.335","article-title":"The cognitive and psychological sequelae of uncomplicated aneurysm surgery.","volume":"54","author":"Maurice-Williams","year":"1991"},{"key":"b26","series-title":"Br J Neurosurg","first-page":"473","article-title":"Cognitive changes in subarachnoid haemorrhage patients with ruptured anterior communicating artery aneurysms in relation to timing of surgery.","volume":"11","author":"Mavaddat","year":"1997"},{"key":"b27","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1227\/00006123-198903000-00009","article-title":"Cognitive outcome and quality of life one year after subarachnoid haemorrhage.","volume":"24","author":"McKenna","year":"1989"},{"key":"b28","series-title":"Br Med Bull","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1093\/oxfordjournals.bmb.a070866","article-title":"Interhemispheric differences in the localization of psychological processes in man.","volume":"27","author":"Milner","year":"1971"},{"key":"b29","series-title":"National Adult Reading Test (NART). Test Manual.","author":"Nelson","year":"1982"},{"key":"b30","series-title":"Neuropsychiat Neuropsychol Behav Neurol","first-page":"260","article-title":"Long-term neuropsychological and psychosocial effects of subarachnoid hemorrhage.","volume":"3","author":"Ogden","year":"1990"},{"key":"b31","series-title":"Neurosurgery","first-page":"572","article-title":"A prospective study of impairment of cognition and memory and recovery after subarachnoid hemorrhage.","volume":"33","author":"Ogden","year":"1993"},{"key":"b32","series-title":"Neuropsychol Rehab","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1080\/09602019408401453","article-title":"A prospective study of psychosocial adaptation following subarachnoid haemorrhage.","volume":"4","author":"Ogden","year":"1994"},{"key":"b33","series-title":"Neuropsychologia","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1016\/0028-3932(90)90137-D","article-title":"Planning and spatial working memory following frontal lobe lesions in man.","volume":"28","author":"Owen","year":"1990"},{"key":"b34","series-title":"Eur J Neurosci","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1111\/j.1460-9568.1996.tb01219.x","article-title":"Planning and spatial working memory: a positron emission tomography study in humans.","volume":"8","author":"Owen","year":"1996"},{"key":"b35","series-title":"Cereb Cortex","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1093\/cercor\/6.1.31","article-title":"Evidence for a two-stage model of spatial working memory processing within the lateral frontal cortex: a positron emission tomography study.","volume":"6","author":"Owen","year":"1996"},{"key":"b36","series-title":"Brain","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1093\/brain\/119.5.1597","article-title":"Double dissociations of memory and executive functions in working memory tasks following frontal lobe excisions, temporal lobe excisions or amygdalo-hippocampectomy in man.","volume":"119","author":"Owen","year":"1996"},{"key":"b37","series-title":"Neuropsychologia","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1016\/0028-3932(91)90063-E","article-title":"Extra-dimensional versus intra-dimensional set shifting performance following frontal lobe excisions, temporal lobe excisions or amygdalohippocampectomy in man.","volume":"29","author":"Owen","year":"1991"},{"key":"b38","series-title":"Neuropsychologia","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/0028-3932(94)00098-A","article-title":"Visuo-spatial short-term recognition memory and learning after temporal lobe excision, frontal lobe excisions or amygdalo-hippocampectomy in man.","volume":"33","author":"Owen","year":"1995"},{"key":"b39","series-title":"Brain Cogn","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/0278-2626(88)90032-2","article-title":"Memory impairment following ruptured aneurysm of the anterior communicating artery.","volume":"7","author":"Parkin","year":"1988"},{"key":"b40","series-title":"J Clin Exp Neuropsychol","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1080\/01688638808402795","article-title":"Cerebral metabolic effects of a verbal fluency test: a PET scan study.","volume":"10","author":"Parks","year":"1988"},{"key":"b41","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"1134","DOI":"10.1001\/archneur.1987.00520230024008","article-title":"Basal forebrain infarction. A clinicopathologic correlation.","volume":"44","author":"Phillips","year":"1987"},{"key":"b42","series-title":"Neurol Psychiatr Brain Res","first-page":"111","article-title":"The neuropsychiatric aspects of subarachnoid haemorrhage: a review.","volume":"3","author":"Politynska","year":"1995"},{"key":"b43","series-title":"Acta Neurol Scand","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1111\/j.1600-0404.1991.tb04659.x","article-title":"Cognitive performance following rupture and repair of intracranial aneurysm.","volume":"83","author":"Richardson","year":"1991"},{"key":"b44","series-title":"Principles of Behavioral Pharmacology. Handbook of Psychopharmacology, Vol 7, Sect 2, Behavioral Pharmacology in Animals.","first-page":"37","article-title":"A critique of the methods available for the measurement of spontaneous motor activity","author":"Robbins","year":"1977"},{"key":"b45","series-title":"Dementia","first-page":"266","article-title":"Cambridge Neuropsychological Test Automated Battery (CANTAB): a factor analytic study of a large sample of normal elderly volunteers.","volume":"5","author":"Robbins","year":"1994"},{"key":"b46","series-title":"Neuropsychologia","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1016\/0028-3932(90)90055-S","article-title":"Sparing of attentional relative to mnemonic function in a subgroup of patients with dementia of the Alzheimer type.","volume":"28","author":"Sahakian","year":"1990"},{"key":"b47","series-title":"Brain","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1093\/brain\/111.3.695","article-title":"A comparative study of visuospatial memory and learning in Alzheimer-type dementia and Parkinson's disease.","volume":"111","author":"Sahakian","year":"1988"},{"key":"b48","series-title":"J R Soc Med","first-page":"399","article-title":"Computerized assessment in neuropsychiatry using CANTAB: discussion paper.","volume":"85","author":"Sahakian","year":"1992"},{"key":"b49","series-title":"Dementia","first-page":"150","article-title":"Detection of visual memory and learning deficits in Alzheimer's disease using the Cambridge Neuropsychological Test Automated Battery.","volume":"2","author":"Sahgal","year":"1991"},{"key":"b50","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1007\/BF01410621","article-title":"Timing of operation for ruptured cerebral aneurysm and long-term recovery of cognitive functions.","volume":"136","author":"Satzger","year":"1995"},{"key":"b51","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"191","DOI":"10.3171\/jns.1986.64.2.0191","article-title":"Outcome evaluation following subarachnoid hemorrhage.","volume":"64","author":"S\u00e4veland","year":"1986"},{"key":"b52","series-title":"Auditorium","first-page":"8","article-title":"The East Anglian Contractual Audit of the management of subarachnoid haemorrhage.","volume":"7","author":"Seeley","year":"1998"},{"key":"b53","series-title":"Phil Trans R Soc Lond [Biol]","first-page":"199","article-title":"Specific impairments of planning.","volume":"298","author":"Shallice","year":"1982"},{"key":"b54","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1227\/00006123-198812000-00002","article-title":"Early aneurysm surgery and prophylactic hypervolaemic hypertensive therapy for the treatment of aneurysmal subarachnoid hemorrhage.","volume":"23","author":"Soloman","year":"1988"},{"key":"b55","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1227\/00006123-198709000-00001","article-title":"Cognition and adjustment after late and early operation for ruptured aneurysms.","volume":"21","author":"Sonesson","year":"1987"},{"key":"b56","series-title":"Acta Neurol Scand","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1111\/j.1600-0404.1989.tb03901.x","article-title":"Cognitive functioning after subarachnoid haemorrhage of unknown origin.","volume":"80","author":"Sonesson","year":"1989"},{"key":"b57","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1136\/jnnp.54.10.909","article-title":"Long-term cognitive deficits in patients after surgery on aneurysms of the anterior communicating artery.","volume":"54","author":"Stenhouse","year":"1991"},{"key":"b58","series-title":"Neurology","first-page":"875","article-title":"Cognitive outcome after aneurysm rupture: relationship to aneurysm site and perioperative complications.","volume":"45","author":"Tidswell","year":"1995"},{"key":"b59","series-title":"Can J Neurol Sci","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1017\/S0317167100026895","article-title":"The relationship between timing of surgery and operative complications in aneurysmal subarachnoid hemorrhage.","volume":"14","author":"Tucker","year":"1987"},{"key":"b60","series-title":"Cortex","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1016\/S0010-9452(85)80007-1","article-title":"Amnestic syndromes after surgery of anterior communicating artery aneurysms.","volume":"21","author":"Vilkki","year":"1985"},{"key":"b61","series-title":"Neurosurgery","first-page":"166","article-title":"Cognitive deficits related to computed tomographic findings after surgery for a ruptured intracranial aneurysm.","volume":"25","author":"Vilkki","year":"1989"},{"key":"b62","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1227\/00006123-199004000-00004","article-title":"Social outcome related to cognitive performance and computer tomographic findings after surgery for a ruptured intracranial aneurysm.","volume":"26","author":"Vilkki","year":"1990"},{"key":"b63","series-title":"Neurology","first-page":"188","article-title":"Positron emission tomography defines metabolic abnormality in medial temporal lobes of two patients with amnesia after rupture and repair of anterior communicating artery aneurysm.","volume":"34","author":"Volpe","year":"1984"},{"key":"b64","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1136\/jnnp.60.3.301","article-title":"An audit of aneurysmal subarachnoid haemorrhage: earlier resuscitation and surgery reduces inpatient stay and deaths from rebleeding.","volume":"60","author":"Whitfield","year":"1996"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/91\/3\/article-p402.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/91\/3\/article-p402.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/91\/3\/article-p402.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T01:52:24Z","timestamp":1679881944000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/91\/3\/article-p402.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,9]]},"references-count":64,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/jns.1999.91.3.0402","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1999,9]]}}}