Bilateral Thrombosis of Anterior Cerebral Artery Following Stimulation of a Hyperactive Carotid Sinus

Stimulation of the carotid sinus, because of its importance in the differential diagnosis of neurologic diseases, has become routine in the complete neurologic examination. The syncope, convulsive seizure, asystole or fall in blood pressure which is produced may frequently be alarming, but there are no reports in the literature of any untoward results following stimulation of a hypersensitive carotid sinus. The present report deals with a case in which, immediately after induction of carotid sinus syncope, a progressive thrombosis of both anterior cerebral arteries developed, which ended fatally. REPORT OF CASE A railroad brakeman aged 53 was seen in neuropsychiatric consultation because of a complaint of emotional instability and mental depression for over two years. He had always been irritable. He had had typhoid in 1902, amebic dysentery, treated with emetine, in 1938 and a severe respiratory infection in September 1940 which had left him with a cough. The general