Valore e limiti della valutazione neuropsicologica nei pazienti operati per aneurisma endocranico

The evaluation of results of endocranial aneurysm treatment remains controversial in spite of the considerable quantity of works presented in the literature. In recent years, long-term results have been evaluated utilizing the Glasgow Outcome Scale (GOS), yet the small number of parameters and the insufficient degree of objectivity considerably limit this method. The introduction of neuropsychological evaluation has marked a considerable turning point in this area. Neuropsychological evaluation has been performed for some time, particularly by a group from the Lund school in Sweden. The results of their studies provided a very articulate clinical picture and satisfactory evaluation of treatment of subarachnoid hemorrhage from bleeding aneurysm. This evaluation method, due to better comprehension of the psycho- cognitive picture, permits a more congruent diagnosis regarding actual patient condition and better definition of the role of the, subarachnoid hemorrhage with respect to surgery in the development of neuropsychological disturbances and deficits of psychosocial reintegration. The acquisition of more precise data on the evolution of long-term cognitive deficits has provided a valid tool for the formulation of improved therapeutic and rehabilitation strategies. Neuropsychological evaluation has provided important data for diagnosis, prognosis, and rehabilitation possibility for patients treated for bleeding aneurysm. However this method of evaluation does have limits due to the personnel and time requirement. Although this method represents a valid tool based on neuropsychological acquisitions in the scientific field and the utility in the diagnostic-prognostic- rehabilitative field, it is unlikely that this method may enter the clinical routine of all patients treated for aneurysm. The cognitive function data represent only an important focal aspect in the overall evaluation of patients treated for aneurysm. Moreover, the acquisition of cognitive functional data needs to be integrated by neurological evaluation and the socio-affective reintegration, which may be provided by the clinical evaluation scale, CESE (Clinical Social Emotional Evaluation), cured by one of us.