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Intraoperative monitoring of the temporary occlusion of the middle cerebral artery was performed in four patients with giant or large aneurysms. Several combined monitorings with somatosensory evoked potentials (SEPs), electroencephalogram (EEG) and direct cortical response (DCR) were recorded. SEPs and DCR showed more sensitive responses to ischemia than those of EEG, both in chronic and acute stages; however, the outcome of the patients corresponded with the findings of the EEG. The particular property of each type monitoring is helpful in comprehensive management of giant or large middle cerebral aneurysms.

The Role of Intraoperative Monitorings for the Management of Giant Middle Cerebral Aneurysms