Why the study?
What are the mechanisms of delayed TIAs in patients with bilateral carotid artery occlusion?
What are the mechanisms of delayed TIAs in patients with bilateral carotid artery occlusion?
Delayed TIAs after bilateral carotid artery occlusion can be caused by both hemodynamic mechanisms and embolic phenomena through collateral pathways.
May support dual mechanisms for delayed TIAs after bilateral carotid occlusion; leaves open prospective studies before guiding practice.
We studied 4 patients with bilateral carotid artery occlusion who suffered delayed TIAs in one of the occluded internal carotid or common carotid areas. Hemodynamic mechanisms were prominent in two patients, in head turning and orthostatic hypotension. In the other two cases, embolic phenomena through the homolateral external carotid collateral pathways were probable, because this artery (or the common carotid artery) showed atheromatous stenosis and major collateral supply to the brain and retina. Different mechanisms may be responsible for further ischemia after bilateral occlusion of carotid arteries.
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Bogousslavsky et al. (1983) studied this question.
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