A 74-year-old woman exhibited sensory aphasia with abrupt blood pressure elevation 3 h after clipping of an unruptured large left middle cerebral artery aneurysm. Perfusion computed tomography and single-photon emission computed tomography demonstrated hyperperfusion in one of the distal parent artery areas. She gradually improved and was discharged without neurological deficits. Increased distal blood flow after occlusion of the large cerebral aneurysm and postischemic reperfusion after temporary occlusion of the parent artery during surgery presumably played an important role in the occurrence of this fairly rare condition associated with aneurysm surgery.

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