Analysis in causes of symptomatic cerebral infarction after middle cerebral artery aneurysm clipping

Objective To analyze the causes of cerebral infarction after artery aneurysm clipping at middle cerebral artery bifurcation.

Methods This study included 31 patients with middle cerebral aneurysms who underwent aneurysm clipping surgery in the Third People′s Hospital of Hubei Province from March 2018 to November 2020.The data of brain CT or diffusion weighted imaging (DWI) images of patients before surgery and within 24 to 48 h after surgery were compared to determine whether there was new cerebral infarction, and the causes of infarction was determined by combining the image and the actual situation of surgery.

Results Of 31 patients, there were 5 patients in cerebral infarction group and 26 patients in non-infarction group.There were no significant differences in age, gender, underlying disease and intraoperative occlusion time between the two groups (P>0.05).Postoperative cerebral infarction occurred in 5 cases, including 1 case with collateral compensation-related cerebral infarction after occlusion, 1 case with carrier artery stenosis related cerebral infarction, 1 case with perforator artery injury related cerebral infarction, and 2 cases of branch atheromatous disease.

Conclusion There are various reasons for the cerebral infarction after clipping of the middle cerebral artery bifurcation aneurysm.The main causes of postoperative cerebral infarction mainly include collateral compensatory vessels, secondary carrier artery stenosis, perforator artery injury and branch atheromatous disease.