No evidence that severity of stroke in internal carotid occlusion is related to collateral arteries

Lothian Stroke Registry Study Group, G E Mead, J M Wardlaw, S C Lewis, M S Dennis

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aim
The neurological effects of internal carotid artery (ICA) occlusion vary between patients. The authors investigated whether the severity of symptoms in a large group of patients with ipsilateral or/and contralateral ICA occlusion at presentation with ocular or cerebral ischaemic symptoms could be explained by patency of other extra or intracranial arteries to act as collateral pathways.
Methods
The authors prospectively identified all patients (n = 2881) with stroke, cerebral transient ischaemic attack (TIA), retinal artery occlusion (RAO), and amaurosis fugax (AFx) presenting to our hospital over five years, obtained detailed history and examination, and examined the intra and extracranial arteries with carotid and colour‐power transcranial Doppler ultrasound. For this analysis, all those with intracranial haemorrhage on brain imaging and cerebral events without brain imaging were excluded.
Results
Among 2228/2397 patients with brain imaging (1713 ischaemic strokes, 401 cerebral TIAs, 193 AFx, and 90 RAO) who underwent carotid Doppler, 195 (9%) had ICA occlusion. Among those patients with cortical events, disease in potential collateral arteries (contralateral ICA, external carotid, ipsilateral or contralateral vertebral or intracranial arteries) was equally distributed among patients with severe and mild ischaemic presenting symptoms.
Conclusion
The authors found no evidence that the clinical presentation associated with an ICA occlusion was related to patency of other extra or intracranial arteries to act as collateral pathways. Further work is required to investigate what determines the clinical effects of ICA occlusion.
Original languageEnglish
Pages (from-to)729-33
Number of pages5
JournalJournal of Neurology, Neurosurgery & Psychiatry
Volume77
Issue number6
DOIs
Publication statusPublished - 2006

Keywords

  • Amaurosis Fugax
  • Brain Ischemia
  • Carotid Artery Diseases
  • Carotid Artery, Internal
  • Functional Laterality
  • Humans
  • Ischemic Attack, Transient
  • Prospective Studies
  • Retinal Artery
  • Severity of Illness Index
  • Stroke
  • Ultrasonography, Doppler, Transcranial

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