Desempenho neurocognitivo de pacientes com malformação arteriovenosa cerebral

• Autor(a) principal: Coelho, Daniela De Souza [UNIFESP]
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7719735; https://repositorio.unifesp.br/handle/11600/59898
• topic: Cerebral Arteriovenous Malformation; Neuropsychological Tests; Cognitive Performance; Cognitive Impairments; Neurologic Symptoms; Malformação Arteriovenosa Cerebral; Testes Neuropsicológicos; Performance Cognitiva; Déficit Neurocognitivo; Sintomas neurológicos

Cerebral arteriovenous malformation (cAVM) is a relatively rare congenital disease that usually occurs in the third to fourth decade of life. Its symptoms vary according to its ruptured and unruptured presentation, however, neurocognitive aspects are not usually addressed in the list of neurological symptoms. Objective: To describe the neurocognitive functions of patients with ruptured and unruptured MAVcs according to the Spetzler-Martin (SM) scale, flow status and anatomical topography. Method: In this partially blind cross-sectional study, 91 patients with cAVM of both genders, aged between 18 and 60 years, were approached. Seventy patients who met the criteria for inclusion in the study were selected for evaluation, and these were evaluated using the Neupsilin Brief Neuropsychological Instrument. Results: Out of 70 patients, 50 (71.43%) with MAVc presented deficits in at least one of the 8 neurocognitive domains surveyed, although they did not present neurological deficits. Of these MAVcs, 50% were unruptured, and no significant difference in memory was observed compared with the group of patients with a MAVc rupture in the temporal lobe. The Spetzler-Martin scale did not influence the results of patients with an unruptured MAVc. We found deficits in working memory in patients with ruptured MAVcs high-grade (SM), and we found deficits in executive function (verbal fluency) in patients with low-grade (SM) MAVcs (p < 0.001). Conclusion: The cAVM patients unruptured e ruptured even without neurological symptoms, already present neurocognitive deficits. The scales that evaluate disability used in the main clinical studies do not evaluate neurocognitive alterations and thus disregard any deficits that affect quality of life. This finding raises an important question about the effects of interventional treatment because it reinforces the hypothesis that cognitive alterations may be pre-existing and not determined by the interventions.