Objectives: The aim of this study was to compare the pre- and postoperative health-related quality-of-life (QOL) and psychological state of patients with asymptomatic unruptured intracranial aneurysms (ICAs) who underwent elective surgery.
Methods: Of 67 patients who underwent neck clipping of ICAs, we assessed the QOL of 61 patients using Short Form-36 (SF-36); their psychological state was rated on the Hospital Anxiety and Depression Scale (HADS) before, 3 months, and 1- and 3 years after treatment.
Results: The preoperative mean scores for each of the 8 SF-36 domains except bodily pain were significantly lower in the study- than the reference population. Fourteen patients (20.9%) experienced surgical complications defined as neurological deterioration and/or abnormal CT findings within 30 days of the operation. Despite some complications, the QOL of all operated patients returned to the mean level of the reference population 3 years post-treatment. At 3 months after surgery, the scores for psychosocial activities and general health perception were transiently below the preoperative levels. According to the HADS, the patients experienced mild anxiety before the operation; it disappeared by the 3rd postoperative month.
Conclusions: Preoperatively, patients with unruptured ICAs reported a significantly decreased QOL. It further declined transiently after elective surgery but within 3 years it returned to the mean level recorded for the reference population. Our findings suggest that these patients derived significant QOL benefits from their surgery. We therefore propose that subjective QOL issues should be considered in deciding whether treatment-related risks and their natural history such as their potential rupture, warrant surgery of asymptomatic unruptured ICAs.
- unruptured intracranial aneurysm