Different Sides of Craniotomy for Anteriorly Superiorly Projecting Anterior Communicating Artery Aneurysm Clipping: Outcome and Long-Term Cognitive Function: A Single-Center Retrospective Study
Bibliographic record
Abstract
BACKGROUND: We explored the impact of various craniotomy approaches on the outcomes and long-term cognitive function of microsurgical clipping for superiorly projecting anterior communicating artery (ACoA) aneurysms. METHODS: We retrospectively analyzed 127 superiorly projected ACoA aneurysms that underwent microsurgical clipping between January 2014 and January 2022. Patients were categorized into 2 types: type 1 (n = 70), characterized by the posterior positioning of the ipsilateral A2 segment (open A2 plane side); and type 2 (n = 57), characterized by the anterior positioning of the ipsilateral A2 segment (closed A2 plane side). The analysis focused on clinical outcomes (modified Rankin Scale score) and long-term cognitive function (Montreal Cognitive Assessment). RESULTS: No significant differences in initial attributes were observed between the 2 groups. No differences were found in modified Rankin Scale score (P = 0.483), cognitive impairment (P = 0.190), or severe cognitive impairment (P = 0.332) between the 2 groups. Furthermore, no significant differences in delayed cerebral ischemia (P = 0.852), delayed bleeding (P = 0.912), or intraoperative rupture (P = 0.141) was found between the 2 groups. However, the occurrence of Montreal Cognitive Assessment subcategories of postponed memory items (P < 0.05) and conceptualization items (P < 0.05) demonstrated a significant decrease on the accessible A2 plane side during a shorter operative time (P = 0.03) and reduced gyrus rectus aspiration frequency (P < 0.001). CONCLUSIONS: The anterior position of the A2 segment can offer better visualization of the aneurysm dome, bilateral A2, and AcoA, leading to reduced operative time and gyrus rectus aspiration frequency, potentially enhancing long-term cognitive function.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".