Key result
Collateral flow preserves neurological function in complete occlusion of all four extracranial vessels.
Why the study?
The correlation between extensive extracranial occlusive disease and minimal clinical symptomatology remains unclear, considering intracranial circulation and collateral flow adaptability.
Case Report (n=1)
Extensive extracranial vessel occlusion can present with minimal clinical symptomatology, highlighting the importance of collateral flow and intracranial circulation adaptability.
Complete four-vessel occlusion may manifest as isolated monocular blindness; leaves open determinants of collateral compensation in cerebrovascular disease.
A case of a 55-year-old man with occlusion of both vertebral, left common carotid and right internal carotid arteries is described. Also present was 95 per cent stenosis on the origin of the right external carotid artery with severe atherosclerotic disease on both subclavian and innominate arteries. Clinical symptoms consisted of blindness of the left eye; otherwise the patient was free of neurological signs. It is suggested that not only the presence of extracranial occlusive disease but also the status of the intracranial circulation, the time factor in which the extracranial vessels became occluded, and the adaptability of the individual to establish all possible means of collateral flow play their roles in correlation of extracranial atherosclerotic disease and clinical symptomatology.
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Vitek et al. (1972) conducted a case report in Occlusion of all four extracranial vessels (n=1). Occlusion of all four extracranial vessels was evaluated on Clinical symptomatology. A 55-year-old man with occlusion of all four extracranial vessels presented with only left eye blindness and no other neurological signs, highlighting the role of collateral flow adaptability.
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