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- W2183624657 abstract "Background: Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating disease with an overall case-fatality of 40-50%. Most of the surviving patients are left with neurological deficits and cognitive impairments. Brain MRI could possibly provide valuable information on patients' recovery potential together with detailed neurological and neuropsychological examination after aSAH. Patients and Methods: One-hundred and sixty-eight consecutive aSAH patients were randomly assigned to either endovascular (n=82) or surgical (n=86) treatment. Altogether 138 conventional and 77 volumetric MRI examinations were available one year after aSAH. T2PD and 3DT1-weighted images were analyzed in detail. Volumetric analyses focused to temporomesial structures; hippocampus (HC) and amygdala (AM), and gray matter (GM) volume loss in patients with ruptured anterior cerebral artery (ACA) aneurysm. The atrophic enlargement of the cerebrospinal fluid (CSF) volumes was quantified. MRI findings were correlated with neuropsychological test scores. Results: Forty-four (31.9%) of 138 patients had no lesions associated with aSAH. According to intention to treat, lesions were more frequent after surgical treatment, predominating in frontal and temporal lobes. Ischemic lesions of the parental artery territory of the ruptured aneurysm were more frequent after surgery. Ischemic lesion volumes correlated with neuropsychological test scores. After aSAH, the HC and AM volumes were found to be smaller than in the matched control individuals. After treatment of an ACA aneurysm, GM atrophy was detected on frontobasal cortical areas and HC ipsilateral to the surgical approach. Enlarged ventricular and sulcal CSF volumes were detected after aSAH. Higher Fisher scores, preoperative hydrocephalus and older age were found to associate with ventricular and sulcal enlargement, both correlating with neuropsychological defects. Conclusion: aSAH is frequently followed by brain parenchymal changes, especially in frontotemporal areas. Lesions seem to be more frequent after surgical than endovascular treatment. Temporomesial volume loss is a common finding after aSAH in general. GM atrophy, principally involving the frontobasal cortical areas and hippocampus ipsilateral to the surgical approach is detected after aSAH and treatment of the ruptured ACA aneurysm. Atrophic CSF-enlargement together with reduced GM volumes is a common sequela after aSAH. Both enlarged CSF-spaces and brain parenchymal lesion volumes correlate with neuropsychological test performance after aSAH. National Library of Medicine Classification: WG 580, WL 355, WN 185 Medical Subject Headings: Amygdala; Aneurysm; Atrophy; Embolization, Therapeutic/methods; Follow-Up Studies; Hippocampus; Humans; Imaging, ThreeDimensional; Intracranial Aneurysm /surgery; Magnetic Resonance Imaging; Neuropsychological Tests; Randomized Controlled Trial; Rupture; Subarachnoid Hemorrhage; Treatment Outcome" @default.
- W2183624657 created "2016-06-24" @default.
- W2183624657 creator A5068094061 @default.
- W2183624657 date "2010-01-01" @default.
- W2183624657 modified "2023-09-27" @default.
- W2183624657 title "Imaging of the Brain After Aneurysmal Subarachnoid Hemorrhage" @default.
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