• Angela F Caveney, Scott A Langenecker, Aditya S Pandey, Laura B Farah, J Alexis Ortiz, Nadia Huq, Runa Bhaumik, B Gregory Thompson, Bruno J Giordani, Donna Auer, and Lewis B Morgenstern.
• Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
• Neurosurgery. 2019 Mar 1; 84 (3): 581-587.

BackgroundEvaluation of differences in neuropsychological outcomes in patients undergoing surgical clipping (SC) vs endovascular coiling (EC) for unruptured cerebral aneurysms is essential in guiding patients seeking treatment of asymptomatic cerebral aneurysms.ObjectiveTo perform a prospective longitudinal analysis of neuropsychological outcomes in patients who underwent microsurgery or coiling for unruptured cerebral aneurysms.MethodsSC (50 patients), EC (35 patients), and healthy controls (43 individuals) were included. A detailed neuropsychological evaluation was performed at baseline and at 2 wk, 3 mo, 6 mo, and 12 mo. Student's t-test was utilized for comparing neuropsychological outcomes among the 3 groups. A mixed-effects model allowed for evaluation of neuropsychological outcome changes among the groups over time.ResultsBoth the SC and EC groups had nonsignificant differences in procedure-related complications. SC patients had the greatest initial declines in short-term memory, fine motor control, and executive functioning; however, these patients also recovered to a greater degree in neuropsychological functionality. Over the next year, all groups achieved similar neuropsychological outcomes with no significant differences among groups.ConclusionWhereas the initial decline in neuropsychological functioning was greater for SC patients, 1 yr after treatment there was no significant difference in neuropsychological outcome among the SC, EC, and healthy control groups.Copyright © 2018 by the Congress of Neurological Surgeons.

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