J Cerebrovasc Endovasc Neurosurg.  2016 Sep;18(3):223-228. 10.7461/jcen.2016.18.3.223.

Relationship between Gyrus Rectus Resection and Cognitive Impairment after Surgery for Ruptured Anterior Communicating Artery Aneurysms

• Joo MS
• Park DS
• Moon CT
• Chun YI
• Song SW
• Roh HG

• KMID: 2355645
• DOI: http://doi.org/10.7461/jcen.2016.18.3.223

Abstract

OBJECTIVE
The gyrus rectus (GR) is known as a non-functional gyrus; hence, its resection is agreed to be a safe procedure frequently practiced to achieve a better surgical view during specific surgeries. This study aimed at comparing the cognitive outcomes following GR resection in patients who underwent surgery for ruptured anterior communicating artery (ACoA) aneurysms.
MATERIALS AND METHODS
From 2012 to 2015, 39 patients underwent surgical clipping for ruptured ACoA aneurysms. Mini-mental state examinations (MMSE) were performed in 2 different periods. The statistical relationship between GR resection and MMSE results was evaluated, and further analysis of MMSE subgroup was performed.
RESULTS
Twenty-five out of the 39 patients (64.19%) underwent GR resection. Mean initial and final MMSE scores in the GR resection group were 16.3 ± 9.8 and 20.8 ± 7.3, respectively. In the non-resection group, the mean initial and final MMSE scores were 17.1 ± 8.6 and 21.9 ± 4.5, respectively. Neither group's scores showed a significant change. Subgroup analysis of initial MMSE showed a significant difference in memory recall and language (p = 0.02) but not in the final MMSE scores.
CONCLUSION
There was no significant relationship between the GR resection and cognitive outcomes in terms of total MMSE scores after surgery for ruptured ACoA aneurysm. However, subgroup analysis revealed a temporary negative effect of GR resection in the categories of language and memory recall. This study suggests that GR resection should be executed superficially, owing to its close anatomical relationship with the limbic system.

Keyword

Anterior communicating artery; Gyrus rectus; MMSE

MeSH Terms

Aneurysm
Arteries
Cognition Disorders*
Humans
Intracranial Aneurysm*
Limbic System
Memory
Prefrontal Cortex*
Surgical Instruments

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