Bilateral Carotid Artery Thrombosis

Cerebral arterial insufficiency secondary to lesions in the cervical portion of the carotid artery is now a well-recognized clinical entity. The employment of cerebral angiography has led to the demonstration of many new facts concerning arterial blood flow and collateral circulation to the brain. The importance of partial or complete occlusion of one internal carotid artery, with disease also present in the contralateral vessel, has received attention in the recent literature.1-3The occurrence of complete bilateral carotid occlusion has been noted at autopsy, or occasionally with angiography, but only 2 detailed studies of antemortem cases have been found in the literature.5,6 Unilateral complete occlusion of one internal carotid artery with or without contralateral disease is a frequent finding in the study of patients with cerebral arterial insufficiency. Gurdjian6recently reported 258 patients with carotid disease, and in this group 131 had complete unilateral occlusion. In this series