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Department of Neurosurgery, Nara Medical University, Kashihara (Received December 19, 1994, Accepted March 3, 1995) Abstract Cases of cerebral aneurysm in the aged has increased recently due to the advance of diagnostic methods. To obtain satisfactory results, complete neck clipping is not the only requisite factor, but also preservation of the blood flow in the parent arteries and perforators is needed. Monitoring of arterial blood flow velocity might be helpful in determining the possibility of stenosis or occlusion in the parent arteries. Forty cases with the mean age of 61 years are included in this study. Measurement of the blood flow velocity of the parent arteries was carried out before and after neck clipping of the aneurysm. The degree of flow change was evaluated as the percent change of the velocity. When the velocity increased or decreased more than 20% to the pre-clipping level, the result was evaluated as abnormal. Twelve cases were evaluated as abnormal, and ten cases of these were found to be aged 65 years and over. Five cases remained at the abnormal level even after topical application of papaverine. Controlled angiography revealed arterial occlusion in one case, and arterial stenosis in 4 out of 5 cases. Monitoring of arterial blood flow velocity shows blood flow in the vessels precisely during aneurysm neck clipping. Accordingly, better results can be expected through the use of this technique.

Intra-arterial blood flow velocity monitoring during the aneurysmal neck clipping