Clinical Neuroscience

[The clinic of internal carotid artery thrombosis]

AMBRÓZY György1

JULY 01, 1959

Clinical Neuroscience - 1959;12(07)

[1. Due to the increasing prevalence of angiogpraphy, carotid internal carotid artery occlusion is being diagnosed more frequently and earlier. We report 13 angiography-verified cases compared with literature data. 2. The aetiology of the pathology often includes vascular diseases (arteriosclerosis, thrombangitis obliterans, arteritis lueticus) and less frequently trauma and embolism. Different aetiological factors may be involved. CIT 3: The possibility of CIT if : a vascular catastrophe with relatively rapid remission occurs in a male patient, mostly middle-aged, usually with normal blood pressure, after symptoms suggestive of "intermittent circulatory insufficiency of the carotid system". Auxiliary diagnostic procedures include carotid sign, palpation of carotid pulsation in the neck, ophthalmodynamometry and EEG. 4. The diagnosis is ensured by the absence of carotid artery angiogram. The picture of carotid artery occlusion may be mimicked by the picture of constricted carotid artery spasm, cerebral circulatory weakness due to high cerebral pressure increase. Sometimes the location of the occlusion on imaging does not correspond exactly to the anatomy. 5 The development of clinical signs and prognosis of the disease are influenced by the anatomy of the circulus arteriosus Willisi, the degree of collateral circulation developed, the time course of the occlusion and general circulatory factors. 6. The pial collateral circulation, which develops as a result of intraluminal pressure drop, oxygen tension drop and blood PH shift, is maintained only with adequate general tensiosyncope, so that in the acute stage, but also in the chronic stage, it is very important to ensure adequate tensiosyncope in addition to cerebral vasodilatation. The results of anticoagulant therapy are uncertain. Surgical solutions include end-end anastomosis, thrombectomy for short segmental occlusion, and bypass of the stenosed segment with plastic tubing for partial carotid occlusion. It is assumed that in such cases, restoring the circulation, in addition to the so-called structure oxygen, will provide the oxygen necessary for function and thus improve neurological symptoms. An early diagnosis of the pathology, preferably at the stage of "intermittent carotid insufficiency", is important for possible surgical therapy.]

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  1. Budapesti Orvostudományi Egyetem Neurológiai Klinikája

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