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To clarify the correlation between middle cerebral artery flow velocity during temporary occlusion of the internal carotid artery (ICA) and post-occlusion neurological deficits, the balloon occlusion test was carried out during pre-operative angiography. Seven patients, were selected (four men and three women; aged 35-70 years) . The diagnosis was carotid bifurcation stenosis in two patients, internal carotid-ophthalmic aneurysm in two, carotid-cavernous fistula in one, ICA aneurysmal dilatation due to aortitis in one, and tumor of the neck in one. Two patients had a transient neurological deficit during the balloon occlusion test. The mean pre-occlusion velocities were Vs: 65, Vm: 48 and Vd: 36 cm/s, and post-occlusion velocities were Vs: 19, Vm: 11.5 and Vd: 7 cm/s, with a decrease of 71%, 76% and 81%, respectively. The pulsatile index increased from 0.67 to 1.19, and the resistance index increased from 0.45 to 0.63. The other five patients without neurological deficits had mean pre-occlusion velocities of Vs: 80.4±9.9, Vm: 55.2±10.1 and Vd: 40±7.8cm/s, and post-occlusion velocities of Vs: 57.6±10.2, Vm: 48.4±10.0 and Vd: 40±7.4cm/s, with a decreased of 30±4%, 14±7% and, 1±4.7%, respectively. The pulsatile index decreased from 0.78 to 0.39 and the resistance index decreased from 0.5 to 0.31. The present results indicate that a decrease in Vm, along with a decrease in Vd, correlate well with post-occlusion neurological deficits.
日本脳神経超音波学会の論文

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