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November 1966

Embolization and Transient Blindness From Carotid Atheroma: Surgical Considerations

Author Affiliations

From the departments of surgery (Drs. Ehrenfeld and Wylie), ophthalmology, and neurological surgery (Dr. Hoyt), University of California School of Medicine, San Francisco.

Arch Surg. 1966;93(5):787-794. doi:10.1001/archsurg.1966.01330050091013

THE ASSOCIATION between intermittent monocular blindness (amaurosis fugax) and atherosclerotic lesions of the ipsilateral carotid artery has become increasingly clear within the last decade. Episodes of transient blindness often occur in patients subject to recurrent transient cerebral ischemic syndromes. It has been suggested that both the cerebral and visual disturbances have an embolic origin.

The present report describes 44 patients with transient monocular visual disturbances and associated ipsilateral carotid artery lesions who were studied at the University of California Medical Center, San Francisco. In this study particular attention was directed toward determining the prognostic implications of intermittent blindness, the likelihood of development of stroke or permanent visual impairment, and the assessment of the value of direct surgical attack on the primary lesion to prevent these sequelae.

Most of the 44 patients with intermittent monocular blindness described their episodes of blindness in a similar manner. They often stated that they felt

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