Neuropsychological rehabilitation in a patient with ruptured anterior communicating artery aneurysm: 48 month outcomes

Bolognani, Silvia Adriana Prado; Covre, Priscila; Landucci-Moreira, Daniella; Rivero, Thiago Strahler; Brucki, Sônia Maria Dozzi; Bueno, Orlando Francisco Amodeo

doi:10.1590/s1980-57642008dn10400014

Cited by 3 publications

(3 citation statements)

References 10 publications

(12 reference statements)

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“…As portrayed in the case of Mrs. B, improvements in this population may take months and even years. This has been noted before by the few existing case studies focusing on the rehabilitation of this population (Deluca and Locker, 1996;Stablum et al, 2000;Bolognani et al, 2007). Anosognosia and memory impairments tend to compromise the process by which survivors learn about what happened to them and how impairments affect them in everyday life.…”

Section: Ttt: Things Take Time!mentioning

confidence: 74%

A Neuropsychological Rehabilitation Framework to Address Cognitive and Neurobehavioral Impairments After Strokes to the Anterior Communicating Artery

Cruces

Muñoz-García²,

Palmer-Cancel³

et al. 2022

Front. Hum. Neurosci.

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Patients with strokes to the Anterior Communicating Artery (ACoA) pose an important challenge to rehabilitation teams due to a particular mix of cognitive and behavioral impairments (anosognosia, anterograde amnesia, prospective memory problems, and executive dysfunction). These deficits often compromise engagement with rehabilitation, learning and generalization. The goal of this article is to describe the long-term presentation of a patient with an ACoA stroke (Mrs. B, a 60-year-old electric engineer) as well as her rehabilitation needs and the many challenges experienced by the rehabilitation team when attempting to facilitate functional, vocational and psychosocial recovery. Based on this case, and the existing literature, a neuropsychological rehabilitation framework to understand and address the specific problems and needs of this population is proposed. This framework demands rehabilitation teams to consider: the slow pattern of recovery of this population, the interaction between cognitive and behavioral impairments, the relevance of physical and social environments, the value of personal projects and the need to include psychological and relational interventions.

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Section: Ttt: Things Take Time!mentioning

confidence: 74%

A Neuropsychological Rehabilitation Framework to Address Cognitive and Neurobehavioral Impairments After Strokes to the Anterior Communicating Artery

Cruces

Muñoz-García²,

Palmer-Cancel³

et al. 2022

Front. Hum. Neurosci.

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“…ACoA aneurysms are often associated with adverse cognitive outcomes, particularly executive and memory dysfunction, presumably because of their anatomic location. 43 This discrepancy may bias neurocognitive outcome measures in favor of endovascular coiling. Furthermore, after a review of the literature, Zaki Ghali et al 44 noted that ACoA aneurysms had significantly better cognitive outcomes if they were treated with endovascular coiling instead of clipping.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Neuropsychological Outcomes After Treatment of Intracranial Aneurysms

Nasra

Weerakkody²,

Maingard

et al. 2022

Neurosurgery

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BACKGROUND: Aneurysmal subarachnoid hemorrhage is a cause of profound morbidity and mortality. Its effects extend beyond functional neurological status to neurocognitive and psychological functioning. Endovascular treatment is becoming more prevalent after increasing evidence for its safety and efficacy; however, there is a relative paucity of evidence specific to neurocognitive status after treatment. OBJECTIVE: To assess and compare neuropsychological outcomes after the treatment of ruptured and unruptured intracranial aneurysms. METHODS: A systematic review of the literature was conducted searching for articles assessing the neuropsychological and cognitive outcomes after the treatment of ruptured and unruptured intracranial aneurysms. Inclusion criteria were English language, publication between January 2000 and October 2020, and discussion of neuropsychological outcomes in adequate detail. Outcomes were categorized into 8 domains: 5 Neurocognitive (Language, Executive Function, Complex Attention, Memory and Learning, and Perceptual motor function), Intelligence Quotient, Affect, and Quality of Life. RESULTS: Twenty-four articles were included comprising 2236 patients (924 surgical clipping, 1095 endovascular coiling, and 217 controls). These studies reported that most tests revealed no significant difference [n = 356/421 (84.56%)] between treatment modalities. More studies reported significantly superior test scores in the fields of language, executive function, and memory and learning after coiling [n = 53/421 tests (12.59%)] compared with clipping [n = 12/421 tests (2.85%)]. CONCLUSION: The current available data and published studies demonstrate a trend toward improved neurocognitive and psychological outcomes after endovascular treatment. Although these findings should be considered when deciding on the optimal treatment method for each patient, drawing definitive conclusions is difficult because of heterogeneity between patients and studies.

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“…In addition, it aims to delimit the expectations for the treatment in a determined time. Thus, the evaluation stage has the 'golden' objective of understanding how cognitive sequelae manifest specifically in the life of the patient (Bolognani et al, 2007) and allow for the definition of the objectives of the rehabilitation, described in Table 2.…”

Section: Rehabilitation Plan and Definition Of The Treatment Goalsmentioning

confidence: 99%

Neuropsychological Intervention in a Case of Korsakoff's Amnesia

et al. 2011

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T he cognitive symptoms that characterise the Wernicke-Korsakoff's syndrome include anterograde amnesia, confabulation, temporal-spatial disorientation, severe apathy, poor awareness of one's own mental state and changes in executive functions. Such deficits may persist even after the clinical profile stabilises. There are no studies that report an intervention after the acute phase, possibly due to the complexity of these cases. This study provides a descriptive analysis of neuropsychological rehabilitation concomitant to the neurological and psychiatric treatment of a woman who presented the symptoms described by Korsakoff. The intervention focused on reducing the impact caused by the cognitive and behavioural sequelae in the patient's daily life. It described a 25-week neuropsychological program, providing education and compensatory strategies for the patient, and also orientation and support from 2 professional caregivers and family members. Quantitative and qualitative measures were used to evaluate the effect of the intervention on memory efficacy, emotional state and social participation. Both caregivers reported a decrease in the frequency of memory lapses after treatment. Positive changes were also seen in self-care, activities at home, decision-making and participation in social activities. It is concluded that this case achieved results through the collaboration between members of an interdisciplinary team and caregivers providing daily support.

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Neuropsychological rehabilitation in a patient with ruptured anterior communicating artery aneurysm: 48 month outcomes

Cited by 3 publications

References 10 publications

A Neuropsychological Rehabilitation Framework to Address Cognitive and Neurobehavioral Impairments After Strokes to the Anterior Communicating Artery

A Neuropsychological Rehabilitation Framework to Address Cognitive and Neurobehavioral Impairments After Strokes to the Anterior Communicating Artery

A Systematic Review of Neuropsychological Outcomes After Treatment of Intracranial Aneurysms

Neuropsychological Intervention in a Case of Korsakoff's Amnesia

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