Carotid Artery Occlusion

Extracranial vascular obstruction as a cause of cerebral ischemia is being recognized with increasing frequency. Carotid artery occlusion as a specific cause of neurologic deficits has drawn our attention since encountering our first case in June, 1956. We have now explored 15 patients suspected of having this ailment, and certain lessons learned seem worthy of report. Special attention will be directed to case selection and surgical management.

Tables 1, 2, and 3 summarize our experience with the 15 patients. The four patients in Table 1 have had no recurrence of neurological difficulties to the present time. That this definitely means patency of the artery cannot be proved authoritatively without postoperative arteriograms. Jackson and Fromm¹ and Gurdjian and Webster² have emphasized the occasional improved patient with angiographic evidence of obstruction not relieved by surgery. Figures 1 and 2 demonstrate the preoperative occlusion and postoperative patency of our first successful