THERE HAS been an increasing interest during the past decade in occlusive disease of the extracranial portion of the internal carotid arteries. Although atherosclerosis is the most common cause of obstruction in these vessels, other occlusive lesions are frequently found, particularly in young and middle-aged patients. Obstruction of the carotid arteries by arteritis,1 trauma,2 kinks, loops, or aneurysms3,4 are all known to produce manifestations of cerebral vascular insufficiency. To our knowledge, however, cerebral ischemia caused by hypoplasia of the internal carotid artery has not been previously reported.
This paper presents two patients with almost identical clinical syndromes of transient cerebral ischemia caused by hypoplasia of the extracranial portion of the internal carotid artery. In both patients, a preoperative diagnosis of atherosclerotic disease was made, and surgical procedures were carried out in an attempt to correct the condition. The clinical, arteriographic, and operative findings of these cases