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Internal Carotid vs Middle Cerebral Artery Occlusions: Clinical Differences

Internal Carotid vs Middle Cerebral Artery Occlusions: Clinical Differences Abstract THE DISTRIBUTION of pathologic changes in the brains of patients dying with occlusion of the internal carotid artery and with occlusion of the middle cerebral artery has been shown to be similar.1-3 It is not surprising, therefore, that the neurological syndromes resulting from occlusion of these arteries may at times be identical, and that the clinical differentiation between them may be quite difficult.4-8 Internal carotid artery occlusion may be suspected if evidence of impaired flow through its first branch, the ophthalmic artery, can be elicited. Thus, transient monocular blindness, ipsilateral reduction of retinal artery pressure, delay in ipsilateral retinal fluorescein circulation time, and, rarely, unilateral optic atrophy, are all generally accepted features of diagnostic importance. More controversial diagnostic signs of carotid occlusion include ipsilateral, local, or contralateral eyeball bruit, diminished pharyngeal pulsations, Horner's syndrome without anhydrosis, dilatation of the superficial vessels of the face, and the response to References 1. Fisher, C. M.: Occlusion of Internal Carotid Artery , Arch Neurol Psych 65:346, 1951.Crossref 2. Turner, B.: Some Aspects of Pathology of Thrombosis of Internal Carotid Artery , Proc Roy Soc Med 47:604, 1954. 3. Berry, R. G., and Alpers, B. J.: Occlusion of Carotid Circulation, Pathologic Considerations , Neurology 7:223, 1957.Crossref 4. Elvidge, A. R., and Werner, A.: Hemiplegia and Thrombosis of Internal Carotid System , Arch Neurol Psych 66:752, 1951.Crossref 5. Riishede, J.: Cerebral Apoplexy , Acta Psych Neurol Scand 32( (Suppl 118) ) 1957. 6. Bull, J. W. D.; Marshall, J.; and Shaw, D. A.: Cerebral Angiography in Diagnosis of Acute Stroke , Lancet 1:562, 1960.Crossref 7. Eiken, M.: Angiographic Examination of Patients With Acute Cerebrovascular Accidents , Danish Med Bull 10:168, 1963. 8. Bladinfi P. F.: Aspects of Cerebrovascular Disease: Investigation of Series of 100 Cases of Clinically Diagnosed "Strokes," Med J Aust 2:733, 1963. 9. Thomson, J. L. G.: Thrombosis of Major Cerebral Arteries , Brit J Radiol 27:553, 1954.Crossref 10. Jacobsen, H. H., and Skinhoj, E.: Occlusion of Middle Cerebral Artery , Dan Med Bull 6:9, 1959. 11. Milletti, M.: Does Clinical Syndrome of Primitive Thrombose of Internal Carotid Artery at Neck Exist? Acta Neurochir 1:196, 1951.Crossref 12. Louis, S., and Lewis, B.: Sensory Disorders in Occlusion of Internal Carotid and Middle Cerebral Arteries , Neurol 13:693, 1964.Crossref 13. Fisher, C. M.: " Cerebral Arterial Occlusion— Remarks on Pathology, Pathophysiology and Diagnosis ," in Clinical Neurosurgery , Baltimore: Williams and Wilkins Co., 1963, vol 9, p 100. 14. Silverstein, A.: Occlusive Disease of Carotid Arteries , Circulation 20:4, 1959.Crossref 15. Lindgren, S. O.: Spontaneous Occlusions of Carotid and Middle Cerebral Arteries , Conf Neurologica 19:351, 1959.Crossref 16. Bladin, P. F.: Radiologic and Pathologic Study of Embolism of Internal Carotid-Middle Cerebral Arterial Axis , Radiology 82:615, 1964.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Internal Carotid vs Middle Cerebral Artery Occlusions: Clinical Differences

SILVERSTEIN, ALLEN; HOLLIN, SIDNEY
Archives of Neurology , Volume 12 (5) – May 1, 1965
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Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1965.00460290024004
Publisher site
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Abstract

Abstract THE DISTRIBUTION of pathologic changes in the brains of patients dying with occlusion of the internal carotid artery and with occlusion of the middle cerebral artery has been shown to be similar.1-3 It is not surprising, therefore, that the neurological syndromes resulting from occlusion of these arteries may at times be identical, and that the clinical differentiation between them may be quite difficult.4-8 Internal carotid artery occlusion may be suspected if evidence of impaired flow through its first branch, the ophthalmic artery, can be elicited. Thus, transient monocular blindness, ipsilateral reduction of retinal artery pressure, delay in ipsilateral retinal fluorescein circulation time, and, rarely, unilateral optic atrophy, are all generally accepted features of diagnostic importance. More controversial diagnostic signs of carotid occlusion include ipsilateral, local, or contralateral eyeball bruit, diminished pharyngeal pulsations, Horner's syndrome without anhydrosis, dilatation of the superficial vessels of the face, and the response to References 1. Fisher, C. M.: Occlusion of Internal Carotid Artery , Arch Neurol Psych 65:346, 1951.Crossref 2. Turner, B.: Some Aspects of Pathology of Thrombosis of Internal Carotid Artery , Proc Roy Soc Med 47:604, 1954. 3. Berry, R. G., and Alpers, B. J.: Occlusion of Carotid Circulation, Pathologic Considerations , Neurology 7:223, 1957.Crossref 4. Elvidge, A. R., and Werner, A.: Hemiplegia and Thrombosis of Internal Carotid System , Arch Neurol Psych 66:752, 1951.Crossref 5. Riishede, J.: Cerebral Apoplexy , Acta Psych Neurol Scand 32( (Suppl 118) ) 1957. 6. Bull, J. W. D.; Marshall, J.; and Shaw, D. A.: Cerebral Angiography in Diagnosis of Acute Stroke , Lancet 1:562, 1960.Crossref 7. Eiken, M.: Angiographic Examination of Patients With Acute Cerebrovascular Accidents , Danish Med Bull 10:168, 1963. 8. Bladinfi P. F.: Aspects of Cerebrovascular Disease: Investigation of Series of 100 Cases of Clinically Diagnosed "Strokes," Med J Aust 2:733, 1963. 9. Thomson, J. L. G.: Thrombosis of Major Cerebral Arteries , Brit J Radiol 27:553, 1954.Crossref 10. Jacobsen, H. H., and Skinhoj, E.: Occlusion of Middle Cerebral Artery , Dan Med Bull 6:9, 1959. 11. Milletti, M.: Does Clinical Syndrome of Primitive Thrombose of Internal Carotid Artery at Neck Exist? Acta Neurochir 1:196, 1951.Crossref 12. Louis, S., and Lewis, B.: Sensory Disorders in Occlusion of Internal Carotid and Middle Cerebral Arteries , Neurol 13:693, 1964.Crossref 13. Fisher, C. M.: " Cerebral Arterial Occlusion— Remarks on Pathology, Pathophysiology and Diagnosis ," in Clinical Neurosurgery , Baltimore: Williams and Wilkins Co., 1963, vol 9, p 100. 14. Silverstein, A.: Occlusive Disease of Carotid Arteries , Circulation 20:4, 1959.Crossref 15. Lindgren, S. O.: Spontaneous Occlusions of Carotid and Middle Cerebral Arteries , Conf Neurologica 19:351, 1959.Crossref 16. Bladin, P. F.: Radiologic and Pathologic Study of Embolism of Internal Carotid-Middle Cerebral Arterial Axis , Radiology 82:615, 1964.Crossref

Journal

Archives of Neurology – American Medical Association

Published: May 1, 1965

References

  • Occlusion of Internal Carotid Artery
    Fisher , C. M.
  • Some Aspects of Pathology of Thrombosis of Internal Carotid Artery
    Turner , B.
  • Occlusion of Carotid Circulation, Pathologic Considerations
    Berry , R. G., and Alpers, B. J.
  • Hemiplegia and Thrombosis of Internal Carotid System
    Elvidge , A. R., and Werner, A.
  • Cerebral Apoplexy
    Riishede , J.
  • Cerebral Angiography in Diagnosis of Acute Stroke
    Bull , J. W. D.; Marshall, J.; and Shaw, D. A.
  • Angiographic Examination of Patients With Acute Cerebrovascular Accidents
    Eiken , M.
  • Aspects of Cerebrovascular Disease: Investigation of Series of 100 Cases of Clinically Diagnosed "Strokes,"
    Bladinfi P. F.
  • Thrombosis of Major Cerebral Arteries
    Thomson , J. L. G.
  • Occlusion of Middle Cerebral Artery
    Jacobsen , H. H., and Skinhoj, E.
  • Does Clinical Syndrome of Primitive Thrombose of Internal Carotid Artery at Neck Exist?
    Milletti , M.
  • Sensory Disorders in Occlusion of Internal Carotid and Middle Cerebral Arteries
    Louis , S., and Lewis, B.
  • Clinical Neurosurgery
    Fisher , C. M.: "
  • Occlusive Disease of Carotid Arteries
    Silverstein , A.
  • Spontaneous Occlusions of Carotid and Middle Cerebral Arteries
    Lindgren , S. O.
  • Radiologic and Pathologic Study of Embolism of Internal Carotid-Middle Cerebral Arterial Axis
    Bladin , P. F.