Blood flow disturbance in perforating arteries attributable to aneurysm surgery

Abstract

The patency of the perforating artery cannot be determined by intraoperative microscopic inspection. Intraoperative motor evoked potential monitoring contributed to the detection of blood flow disturbance in the territory of the AChA and LSA.

Multiple Intraoperative Monitoring-Assisted Microneurosurgical Treatment for Anterior Circulation Cerebral Aneurysm

“…Among patients with cerebral aneurysm, 5.2% have been found to exhibit residual aneurysms and 4.4% experience cerebral infarction because of blood flow disturbance in perforating arteries after microneurosurgical treatment. 1,2 To our knowledge, however, only a few studies have examined the methods for direct and rapid detection of residual aneurysms and the prediction of ischaemic events.…”

Morphometric analysis, region of supply and microanatomy of the lenticulostriate arteries and their clinical significance

“…[18][19][20] Nevertheless, it is possible that the LSA blood flow will be disturbed during aneurysm surgery, resulting in focal ischemia. 21 The most proximal LSA in our study were observed to originate only 2-3 mm from the carotid bifurcation. In addition, the curves or loops of some LSA were positioned just superior or lateral to the ICA bifurcation.…”

Structure and immunohistochemistry of the human lenticulostriate arteries

“…Thus, the radiologists and neurosurgeons sometimes register a compression of the thin-walled LSAs by an aneurysm of the parent vessel, which is accompanied by the capsular or ganglionic ischaemia [21,24]. The LSAs can also be damaged or become less patent in the course of neurovascular operations, for instance, when dissecting the perforating vessels from the wall of an aneurysm, placing a clip on the aneurysm neck, or applying a temporary MCA occlusion, as well as by direct iatrogenic injury to the LSAs [7].…”