Cognitive and Emotional Recovery After Multiple Embolization for Ruptured Brain Aneurysms Post COVID 19: A Targeted Neurotherapy Case Study

Cognitive and emotional disturbances are increasingly reported in patients recovering from SARS CoV 2 infection, particularly when complicated by cerebrovascular events. This study examines the recovery of cognitive and emotional functioning in a female patient who experienced COVID 19 followed by ruptured intracranial aneurysms requiring multiple neurosurgical interventions. The aim was to evaluate the effectiveness of targeted neurotherapy during the post embolization rehabilitation process and to document the patient’s functional improvement.A 41 year old female patient contracted COVID 19, confirmed by PCR testing, and required two weeks of oxygen therapy. Shortly after discharge, she developed worsening headaches, nausea, vomiting, and right leg numbness. On November 2, 2020, she presented with speech disturbances and right sided weakness. CT angiography revealed subarachnoid hemorrhage and three saccular aneurysms: one at the anterior communicating artery and two at the middle cerebral artery bifurcations. She underwent embolization of the ruptured ACoA aneurysm, followed by elective pterional craniotomies with clipping of the left (January 21, 2021) and right (July 6, 2021) MCA aneurysms. All procedures were completed without complications, and she was discharged in good neurological condition. Despite stable postoperative recovery, the patient reported persistent difficulties in attention, memory, and emotional functioning. Neuropsychological assessment, quantitative EEG, event related potentials (ERPs), and sLORETA tomography revealed dysfunction of the premotor cortex in two independent ERP components during a GO/NOGO task. Based on these findings, an integrated neurotherapy program was implemented, combining EEG based neurofeedback with structured art therapy, delivered twice weekly over 10 weeks. Following treatment, the patient demonstrated significant improvement in sustained attention, working memory, executive functioning, and emotional stability.This case highlights the potential benefits of combining EEG based neurofeedback with art therapy in the recovery of cognitive and emotional disturbances following COVID 19 infection and neurosurgical treatment of ruptured brain aneurysms. Integrated neurotherapy may support neuroplasticity, enhance frontal lobe functioning, and facilitate return to daily activities in complex post neurosurgical cases.