Structural and Clinical Predictors of Cognitive Impairment After Surgical Treatment for Ruptured Cerebral Aneurysms

Aneurysmal subarachnoid hemorrhage (aSAH) is associated with substantial morbidity, even among patients who remain functionally independent after treatment. Late cognitive deficits, particularly involving memory, attention, and executive function, are common in patients undergoing microsurgical clipping of ruptured cerebral aneurysms; however, the underlying mechanisms remain poorly understood. This study aims to identify clinical, acute radiological, and late structural predictors associated with cognitive impairment in these patients.

Participants will undergo a standardized late postoperative brain magnetic resonance imaging (MRI) evaluation (\>1 year after treatment). Structural imaging variables to be analyzed as potential predictors of cognitive impairment include the presence or absence of hippocampal atrophy, frontal lobe atrophy, posterior cerebellar atrophy, pituitary gland atrophy, and deep gray nuclei atrophy, as well as quantitative measurements of white matter hyperintensity volume on FLAIR MRI, residual infarct volume, and cerebral perfusion. These imaging variables will be evaluated in combination with clinical and acute radiological characteristics to identify independent predictors of late cognitive impairment.

• EuroQol 5-Dimension 5-Level (EQ-5D-5L) [Срок оценки: Through study completion, an average of 3 years]
• Hospital Anxiety and Depression Scale (HADS) [Срок оценки: Through study completion, an average of 3 years]
• Modified Rankin Scale (mRS) [Срок оценки: Through study completion, an average of 3 years]
• Return to work [Срок оценки: Through study completion, an average of 3 years]
• In-hospital complications [Срок оценки: Through study completion, an average of 3 years]