Behavioral profile of unruptured intracranial aneurysms: a systematic review

OBJECTIVES: To systematically review the literature on the neuropsychological, psychosocial, and functional profiles of patients with unruptured intracranial aneurysms. METHODS: This review was limited to peer-reviewed research articles that reported cognitive, psychosocial, and/or functional profiles of patients with unruptured intracranial aneurysms. Studies were identified through Medline and PsychINFO by searching “(unruptured [intracranial OR cerebral] aneurysm) AND (cogniti* OR neuropsycholog* OR anxiety OR depression OR [quality of life] OR work OR employment OR [activities of daily living] OR [instrumental activities of daily living]).” Only articles that were published since January 1997 were considered. Reference lists of included articles were inspected for additional studies. Only articles in English were included. Case studies were excluded. Twenty-two articles were included in this review. RESULTS: The literature demonstrates that although treatment for unruptured intracranial aneurysms allays anxiety, it also results in an observable, though transient decline in cognition and daily functioning. Even before treatment, preliminary evidence hints that these patients are not free of such impairments. CONCLUSIONS: The algorithm that underlies the decision to treat an unruptured intracranial aneurysm ought to add more weight to the neuropsychological, psychosocial, and functional profiles of these patients. The clinical relevance of these patients does not begin and end with their risk of rupture.