Syndrome of Carotid Artery Insufficiency

D R. IA)(iIE: Carotid artery insufficiencv is a relatively common lut frequently unirecoogitized syndrome. Fisher' in 432 consecutive autol)sies in which the brain and carotid arteries were studied found 28 cases of (ompl)lete occlusion of one or both carotid arteries. TIi irteen cases showed very severe narrowineg of the arterial lumina, making a total of 9.5 per cent with advanced carotidl disease. The classic concept of carotid artery thronhol)(sis, Iiamely monocular blindness and contralateral hemiplegia, is the exception rather than the rule, since visual (listurbances occur in on0ly\ 15 per cent. Furthermorc, about 15 per cent of l)atients with carotid artery thronibosis miay have no synliptoms.' Like atherosclerotic occiusiotis in other vessels, occlusion of the internal carotid artery is more common ini the male over 40, although the age gronl) varies from 13 to 85 years. Occlusions ini the younger age group are not infrequent. Am my disease process producing occlusive vascular disease may be implicated. By far the most frequent offender is atherosclerosis with a normal bloo1( pressure. Hypertensive persoits for some unknown reason are less frequently affected by this syndrome. Angiitis of any cause, trauma, embolus, comlpression of the internal carotid by the lateral process of the atlas,2 and rarely syphilis have been implicated.