Neurologic sequelae with internal carotid artery occlusion
G. M. LaMuraglia, R. C. Darling, D. C. Brewster and W. M. Abbott
A retrospective review of the clinical course surrounding internal carotid
artery occlusion (ICO) was undertaken in 97 patients with 106 instances of
ICO. No neurologic symptoms could be attributed to more than half of the
ICOs. Of the 52 symptomatic occlusions, 19 (37%) were associated with
transient ischemic attacks and 33 (63%) with fixed strokes. Only 10% of all
patients had permanent disabling neurologic sequelae. There was no
correlation between development of neurologic symptoms and the side of the
ICO, the presence or severity of contralateral carotid artery disease, or
other risk factors. Women, however, were twice as likely as men to develop
a fixed stroke with ICO. Seventy-six of these patients underwent
reconstructive carotid surgery. Although there was a high rate of abnormal
intraoperative findings with electroencephalographic monitoring (32 of 62
cases), with the use of intraoperative shunts there was no increase in the
postoperative stroke complication rate (1.8%). These data suggest that the
concern that ICO leads to serious fixed neurologic deficits may be
overestimated, and that its presence does not adversely affect carefully
performed contralateral carotid endarterectomy.