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November 1941

NEUROLOGIC SYMPTOMS FOLLOWING EXTENSIVE OCCLUSION OF THE COMMON OR INTERNAL CAROTID ARTERY

Author Affiliations

BALTIMORE

From the subdepartment of Neurology, Johns Hopkins University, and the Department of Medicine, Baltimore City Hospitals.

Arch NeurPsych. 1941;46(5):835-842. doi:10.1001/archneurpsyc.1941.02280230077005
Abstract

Occlusion of the carotid vessels is not a rare lesion. Since the introduction of surgical treatment for pulsating exophthalmos, intracranial aneurysms and uncontrollable nasal hemorrhage by ligation either of the common carotid or of the common and internal carotid arteries, many cases with neurologic residua have been reported. However, the changes following surgical ligation rarely show the clearcut syndromes produced by the extensive spontaneous closure of these vessels. The operations are usually performed on young persons in whom the collateral circulation seems satisfactory, so that the loss of nerve tissue is kept to a minimum. Even in the most extensive ligation, as practiced by Dandy1 and others,1a the length of the vessels occluded is not as great as that produced by sudden thrombosis or by an embolus with a long thrombus behind it.

When spontaneous closure of the carotid arteries on one side occurs, the thrombus may extend

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