Pre- and intraoperative methods of controlling cerebral circulation in XXXX surgery.

@entity1 @entity439 @entity63
The surgical treatment of @entity439 usually requires temporary clipping of the aneurysmatic vessel. In planning the surgical approach and in applying temporary clips, the surgeon must consider collateral circulations. The functional integrity of the collateral vessels frequently decides the @entity1 's outcome. In 8 @entity1 with internal carotid artery @entity439 , measurements of blood flow velocities in the ipsilateral middle cerebral artery were performed preoperatively with transcranial Doppler ultrasound (TCD) during manual occlusion of the carotid artery at the neck. Three different perfusion patterns were established, and each collateral capacity was rated as insufficient, temporarily sufficient, or long-term unproblematic. Surgical strategies were conceived. In one @entity1 with @entity439 of the middle cerebral artery the temporary occlusion test was not carried out preoperatively. Intraoperatively, collateral circulation was controlled using microvascular Doppler sonography (MVD). In 8 cases cortical blood flow (CoBF) was monitored by thermal diffusion flow probe and/or laser Doppler. In some cases, the complex pathological anatomy required a change in surgical strategy and a new MVD determination of collateral capacity. Despite these precautions 2 @entity1 suffered @entity63 of the basal ganglia and the white matter.
