1naresh
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Patient 1 2 3 4 5 6 7 8 9 10 Age (yr) (sex) 52/M 42/M 39/M 45/M 54/M 45/M 69/M 55/M 39/M 59/F Ruptured/unruptured R R R R R R U R R U CT gradea 3 4 3 3 4 3 NA 4 4 NA Treatment Trap Clip Clip 2nd Clip Clip Clip Clip Clip Clip Clip Months from treatmentb 2 4 4b 3 13 3 3 5 3 4 MMSEc 24 25 26 28 25 28 26 24 23 27 IQd 82 97 111 110 120 106 102 83 89 92 MQe 58 59 68 92 92 87 86 64 68 67 IQ minus MQ 24 38 43 18 28 19 16 19 21 25 Attention/concentration 81 80 114 138 131 115 115 91 94 133 Delayed recall <50 <50 <50 <50 64 73 62 <50 <50 <50
Note:—R indicates ruptured; U, unruptured; MMSE, Mini-Mental State Examination; IVH, intraventricular hemorrhage in the bilateral lateral ventricles; Trap, trapping; Clip, clipping; NA, not applied; WAIS-III, Wechsler Adult Intelligence Scale III; WMS-R, Wechsler Memory Scale-Revised.
↵a CT grade, proposed by Claassen et al,39 classifies the severity of aneurysmal subarachnoid hemorrhage on CT scans at onset into 5 grades from 0 to 4, according to the appearance of both of SAH and intraventricular hemorrhage in the bilateral lateral ventricles: grade 0, no SAH or IVH; grade 1, minimal SAH, no IVH; grade 2, minimal SAH, with IVH; grade 3, thick SAH, no IVH; grade 4, thick SAH, with IVH. In this scaling, the definition of “thick” is “completely filling” ≥1 cistern or fissure. In 2 patients with unruptured aneurysm (patients 7 and 10), grading was not applied.
↵b Months after second clipping.
↵c MMSE, used to assess cognitive impairment (full score 30).40
↵d IQ evaluated by the Wechsler Adult Intelligence Scale III.18
↵e MQ, general memory quotient, attention/concentration quotient, and delayed recall quotient, evaluated by Wechsler Memory Scale-Revised.19 Each quotient has a mean of 100 in the normal population and an SD of 15. A substantial difference between IQ (by the WAIS-III) and MQ (by the WMS-R) scores indicates that the person with amnesia has a particular impairment in memory—but not in the “intelligence” per se.20