Clinical Neuroscience

[Neuropathological changes associated with internal carotid artery occlusion]

GALLAI Margit1

JUNE 01, 1959

Clinical Neuroscience - 1959;12(06)

[The author reported 9 cases of unilateral and 1 case of bilateral internal carotid artery occlusion, one of embolic origin, seven of sclerotic and two of sclerotic thrombangitis obliterans. On the basis of these studies, he believes that, in addition to internal carotid artery occlusion, the presence of concomitant general vascular disease contributes significantly to the clinical signs, the formation and location of necrosis. In particular, the patency of the circle of Willis, its developmental abnormalities and pathological changes are relevant. The obstruction of the basal collateral circulation facilitates the continued spread of thrombus into the media and anterior trunk in fresh carotid occlusion. Continuous spreading found only in association with fresh occlusion suggests that this fresh thrombus in and distal to the circ. art. of Willis, like emboli, may later recanalize leaving behind locally organized thrombus fragments. From the fragmenting fresh thrombus, microemboli may enter the peripheral small vessels, causing patchy ischaemic lesions. In 10 cases, 11 internal carotid arteries were occluded. The media area on the same side was damaged in all cases. In 3 cases in which compensation by circ. art. Willisii was anatomically unobstructed, only microscopically. In all cases of anterior area softening, the distal trunk of the a. cer. ant. was always completely or partially occluded from the a. communicans ant. Adequate blood supply to the a. cer. post. area is ensured by the basilar system even when it arises from the carotid artery by a thicker branch. If, however, the posterior trunk is occluded distal to the circle of Willis, the whole area of supply is damaged. Despite internal carotid artery occlusion, the hemispheric artery remained macroscopically intact in two cases where anatomically intact basal and pial collateral circulation was possible.]


  1. Budapesti Orvostudományi Egyetem Neurológiai Klinika



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