• Andrea Pietrantonio, Sokol Trungu, and Antonino Raco.
• Department of Neuroscience, Mental Health and Sensory Organs - Division of Neurosurgery, S'Andrea Hospital, University of Rome "Sapienza", V. Suvereto n.240, Rome, 00139, Italy. andrea_pietrantonio@libero.it.
• Acta Neurochir. Suppl. 2017 Jan 1; 124: 173-177.

BackgroundAnterior communicating artery (ACoA) aneurysms have a high risk of rupture. Morbidity and mortality following rupture are higher than at other sites. The aim of this study was to evaluate the long-term clinical and neuropsychological outcomes of patients treated for ruptured and unruptured ACoA aneurysms: a comparison between surgical and endovascular treatment was performed.MethodAll patients surgically or endovascularly treated for ruptured and unruptured ACoA aneurysms at our institution between January 2011 and December 2013 (n=50) were retrospectively reviewed. The Glasgow outcome score and the following neuropsychological tests were used to define the clinical and neuropsychological outcomes, respectively: The Stroop color and word test and the Stroop interference score digit span forward and backward test, phonemic and semantic verbal fluency tests, Rey auditory verbal learning test, comprehensive trail making test, and the Beck Depression Inventory.Findings28 patients (56 %) underwent surgical treatment and 22 (44 %) endovascular coiling; there were 31 (63 %) ruptured and 19 (37 %) unruptured aneurysms. At 1 year follow-up for ruptured aneurysms, clinical outcome was better in the endovascular group; neuropsychological assessment showed a greater deterioration only in the memory domain in the patients treated surgically for ruptured aneurysms.ConclusionThe presence of subarachnoid hemorrhage is more important than the type of treatment in determining the clinical and neuropsychological outcomes of ACoA treatment; these outcomes can be improved by adequate rehabilitation protocols.

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