Cerebral Blood Flow: Iii and Iv

III. CEREBRAL EFFECTS OF OCCLUSION OF THE COMMON OR INTERNAL CAROTID ARTERIES The efficacy of the circle of Willis in establishing an adequate collateral circulation following occlusion of one of the internal or common carotid arteries has long been a matter of dispute. Advocated as a relatively harmless procedure by some authors, ligation of the carotid artery has been regarded by many others as an extremely hazardous operation, to be undertaken, if at all, in only the most desperate circumstances. One has only to read the following directly contradictory quotations from two eminent American surgeons to appreciate how widely divergent are the opinions on this subject: Rudolph Matas,1in 1911, wrote: A long and abundant experience with the surgery of the carotid artery, amounting in a period of twenty-five years to over seventy-eight ligations and extirpations of the common trunk and its two branches, has fully convinced me that