ABSTRACT
The treatment outcome of cerebral aneurysms is influenced by several factors. Surgical treatment may have the evolution affected by the occurrence of cerebral ischemia resulted from inadvertent clipping of adjacent vessels. The risk of future aneurysm bleeding increases when incomplete aneurysm occlusion is done. The use of intraoperative Doppler to study the hemodynamics of aneurysms and adjacent vessels has been advocated as an assistant tool with recent analyzes of the safety and reliability. This case aims to present and discuss the situation in which after the initial clipping of the aneurysm, considered appropriate under the microscope, the Doppler showed residual intra-aneurysmal flow, and additional measures were done for the occlusion of the aneurysm.