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July 1987

Management of Radiation-Induced Accelerated Carotid Atherosclerosis

Author Affiliations

From the Divisions of Neurosurgery (Dr Loftus), and Thoracic-Cardiovascular Surgery (Dr Hiratzka), and the Departments of Neurology (Dr Biller), Pathology (Dr Hart), and Radiology (Dr Cornell), The University of Iowa Hospitals and Clinics, Iowa City.

Arch Neurol. 1987;44(7):711-714. doi:10.1001/archneur.1987.00520190023011

• Patients with long survival following cervical irradiation are at risk for accelerated carotid atherosclerosis. The neurologic presentation in these patients mimics naturally occurring atheromatous disease, but patients often present at younger ages and with less concurrent coronary or systemic vascular disease. Hypercholesterolemia also contributes to this accelerated arteriosclerosis. Angiographic findings in this disorder include disproportionate involvement of the distal common carotid artery and unusually long carotid lesions. Pathologic findings include destruction of the internal elastic lamina and replacement of the normal intima and media with fibrous tissue. This article describes two surgical patients with radiation-induced accelerated carotid atherosclerosis who typify the presentation and characteristics of this disease.