Abstract
Follow-up study of 50 cases with directly operated anterior communicating aneurysm was made, ranging from 6 months to 5 years and 6 months. Forty six cases were alive and the condition of all these cases was evaluated through questionnaires, and 42 cases of them were examined utilizing the WAIS and Y-G test. Four patients out of 46 cases showed decreased ADL and they needed help in their daily activity. About 60% of the cases have resumed full activity of previous occupation, although 68% of the 46 cases have complained of slight headache, forgetfullness and worries about their illness being never cured. The number of cases with the above complaints decreased markedly 2 years after surgery was performed. Verbal IQrecovered sooner than Performance IQobtained on WAIS, and the profile of recovery showed quite a resemblance in the repeated WAIS. Comparing pre and post-operative cases in short term the cause of the poor IQ at present study was considered due to subarachnoid hemorrhage itself rather than to surgical intervention. Poor preoperative condition, such as grade III, IV, of Hunt and Hess, showed delay in recovery. There was no definite evidence of disturbing IQrecovery by angiospasm, ventricular dilatation, direction of aneurysm etc., as far as preoperative grade I, and II groups were concerned. The ultimate evaluation of the patient in regard to social adaptability from IQ test required a 2 year period. Symptoms of so called normal pressure hydrocephalus due to subarachnoid hemorrhage showed sometimes remarkable recovery of the mental state after shunt operation, but in other cases, shunt procedure failed to show persistent effect and several patients showed good IQ in the follow-up study, although the shunt device lost patency in early stage of follow-up. Y-G test showed interesting fact that the cases of poor IQ, especially poor Performance IQ, assumed types of passive adaptability.
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