Prognosis of Symptomatic Intracranial Obstruction of Internal Carotid Artery

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Abstract
Patients with intracranial obstruction of an internal carotid artery (ICA) (15 stenoses, 6 occlusions) were studied for angiographic, clinical and prognostic evaluation. Evidence of atheromatous changes and associated risk factors did not significantly differ from age- and sex-matched controls with extracranial ICA disease. No significant difference occurred between matched groups with extra- or intracranial ICA obstruction in functional outcome, delayed strokes, TIA [transient ischemic attack] and death, suggesting that prognosis was more related to age, sex and degree of obstruction than to level of obstruction. Intracranial stenosis patients (80%) had the worst functional outcome, stenosis patients (30-60%) the best, and occlusion patients were intermediate. This corresponded to higher risk of delayed stroke in patients with 80% stenosis. The prognosis was better in patients without evidence of proximal atheromatosis. Only 1 patient with intracranial occlusion suffered delayed homolateral TIA in which atheromatous embolization from stenosed contralateral ICA was hypothesized.