Visual spatial gnosis and visual constructive activity in patients before and after embolization of intracranial aneurysms

Aim. The study was aimed at examining visual spatial gnosis and visual constructive activity in patients with cerebral aneurysms of anterior circulation before and after endovascular embolization with flow-diverter stents. Methods. Nineteen patients were examined before and after embolization of aneurysms. Patients were asked to perform 5 tests: determining the time on an “empty” dial (without numbers); setting the clock hands on an “empty” dial for the given time; drawing a human figure using the left and right hands; copying the picture of a house from the sample; copying from memory the Rey-Taylor and the Rey-Osterrieth complex figures. Results. Group differences between single measures obtained before and after the surgery were not statistically significant in any of the tests. At the same time, dependency on the hand used for drawing was nearly significant for postoperative changes in human figure drawing quality: the quality of figures drawn using the right hand became on average better after surgery, while the figures drawn using the left hand got worse. Postoperative individual changes demonstrated a “mosaic” pattern for the whole set of the tests, i.e. in most patients the results improved in some test(s) but degraded in other(s) and patterns of these changes differed between the patients. Conclusion. Postoperative changes in visual spatial gnosis and visual constructive activity are of a “mosaic” nature, supposedly due to multiple brain microlesions without certain localizations. At the same time, the differences between changes in the quality of human figures drawn using the right and left hands could be a sign of relative prevalence of the right hemisphere lesions. But in general, there were no significant postoperative changes in the brain integrative activity within the visual-spatial modality after endovascular aneurysm surgery with flow-diverter stents.