Personality Change after Aneurysmal Surgery of Anterior Communicating Artery

ABSTRACT

The neuropsychological consequences of ruptured intracranial aneurysms are being given increasing attention with the recent increase in survival by surgical repair of the aneurysms. The territory of anterior communicating artery(AcoA) seems to be particularly susceptible to neurobehavioral impairments. They include amnesia. Confabulation, and personality change. The neurobehavioral changes have been collectively referred to as the "AcoA syndrome". The study of amnesia and confabulation was extensive for several decades, but the personality change after anterior communicating artery aneurysm rupture seems to have been given less attention. The present study used the MMPI to assess the personalities of 15 AcoA aneurysmal patients and a control group of 19 patients with subarachnoid hemorrhage from aneurysms located at other sites. Overall, AcoA patients showed no remarkable differences in personality in comparison with the control group. However, 5 patients with abnormal MMPI profiles that have abnormally incre ased depression subscale score and an associated increased scores on psychopathic deviance, hysteria, psychasthenia and schizophrenia subscales were detected by cluster analysis, and 4 of them had causable focal lesions such as basal forebrain, ventromedial frontal lobe, and medial frontal lobes about interhemispheric fissure on brain CT. Also, a group with the worst initial clinical state, Hunt and Hess grade IV, developed more personality impairment than the group with Hunt and Hess grade I-II-III regardless of the aneurysmal location. They showed increased scores on depression, psychopathic deviance and schizophrenia subscales.