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January 1953

PROBLEMS RELATED TO TREATMENT OF INTRACRANIAL ANEURYSMS BY CAROTID LIGATION

Author Affiliations

NEW YORK

From the Department of Neurological Surgery, Columbia University College of Physicians and Surgeons, and the Neurological Institute.

AMA Arch NeurPsych. 1953;69(1):118-128. doi:10.1001/archneurpsyc.1953.02320250124013
Abstract

THE PURPOSE of carotid ligation in the treatment of intracranial aneurysms is to reduce the pressure and pulsation within the aneurysm so as to decrease the size of the aneurysm and allow thickening of the walls, and thereby to relieve the compression of adjacent structures and to diminish the possibility of rupture. This purpose is not attained, however, if subsequently, through the presence or the development of sufficient collateral circulation, the blood pressure regains its original level while the aneurysm is still present in the same form. Fortunately, in some cases clotting within the aneurysm, as a result of the reduced pressure and subsequent organization and strengthening of the wall of the aneurysm, obliterates or reduces the lumen of the aneurysm. In such a case return of the pressure would be less likely to result in the reexpansion of the aneurysmal sac or in rupture.

Carotid ligation may theoretically lead

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