DETECTION OF CEREBRAL HYPOPERFUSION DURING TRIAL CAROTID OCCLUSION WITH REVERSAL FOLLOWING EXTRACRANIAL-INTRACRANIAL BYPASS PRIOR TO PERMANENT OCCLUSION

The authors describe a patient with a large intracavernous aneurysm of the right internal carotid artery and a marked decrease in focal brai n blood flow induced by temporary carotid balloon occlusion. The patie nt subsequently underwent a superficial temporal to middle cerebral ar tery bypass followed by successful carotid occlusion using detachable balloons placed proximal to the aneurysm. Postoperative rCBF demonstra ted normal perfusion in the region of the right internal carotid arter y distribution as well as normalization of perfusion to a previous are a of baseline perfusion abnormality. Cerebral brain blood flow imaging was useful in the initial evaluation as well as the management of thi s patient.