Confabulation following aneurysm of the anterior communicating artery

Nine subjects with aneurysms of the anterior communicating artery (ACoA) and 17 subjects with other intracranial hemorrhages (ICH) were evaluated for confabulatory responses under two naturally occurring conditions: (1) when subjects were not oriented to person, place, month and year, (2) when subjects were fully oriented. Confabulation was observed in all 9 of ACoA patients both during disoriented and oriented periods. In contrast, 7/17 of the other ICH patients showed signs of confabulation while disoriented, whereas only one continued to display confabulatory tendencies while fully oriented. Confabulation was more severe in the ACoA group. These data suggest that the confabulation observed in the other ICH group may be secondary to an acute confusional state while the prolonged confabulation in ACoA patients may be a manifestation of a more primary cerebral disorder.