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KMID : 0359819930220091006
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Journal of Korean Neurosurgical Society
1993 Volume.22 No. 9 p.1006 ~ p.1015
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Transient Arterial Stenosis at the Site of Temporary Clipping an Vasospasm Distal to It
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Abstract
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The authors studied for 20 operated cases of aneurysm which was able to follow-up examination of Transcranial dopple sean. In these patients, we performed temporary clippings at the proximal sites of aneurysms in 12 cases (TC group) and the other
8
patients were not perforemd (non-TC group).
Transcranial Doppler and Digital Subtraction Angiography was performed at preoperative and postoperative period at all patients.
We found that transient arterial stenosis was detected at the site of prolonged temporary clipping (45 min due to premature rupture) by TCD and DSA in 1 case. It was at the supraclinoid portion of ICA and the patients had single right MCA
aneurysm.
The preoperative vassopasm had been found in 4 cases, subclinical in 3 cases and transientl motor weakuess in 1 case.
The postoperative vasospasm occured in 6 cases of TC group (2 clinical). and no case in non-TC group. There were 1 case of left Al, 5 cases of left Ml and 2 cases of right Ml, 3 cases of left ICA and 1 case of right ICA.
There was no close relationship between the findings of TCD and DSA, and he spastic range of vasospasm was above 150 cm/sec by TCD.
Thus temporary clipping tends to increase the incidence of postoperative vasospasm, and rather definite after long duration of its application. The anierial stenosis was transient.
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