内頸動脈瘤術中術後におけるCBF測定の意義-クリッピング困難例を中心に-

抄録

Ten patients with internal carotid aneurysms were managed by internal carotid artery (ICA) ligation. Pre-, intra- and post-operative regional cerebral blood flow (rCBF) were measured by the heat clearance method and ¹³³Xe inhalation method.
Abrupt ICA occlusion was carried out in one case, abrupt ICA occlusion combined with EC-IC bypass was carried out in three cases, and gradual ICA occlusion combined with EC-IC bypass was carried out in six cases.
During ICA occlusion, rCBF were reduced less than 20% in six cases and more than 50% in four cases. Permanent cerebral ischemia occurred in four cases, and transient cerebral ischemia occurred in one case. In four cases with ischemic complications, reduction of CBF was more than 50%.
Measurement of CBF might be useful for the prediction of cerebral ischemia in the therapeutic ligation of the cervical ICA.