Intracranial embolization via external carotid artery: report of a case with angiographic documentation.

Publisher Website
Google Scholar
Abstract
A patient developed delayed recurrent retinal and hemispheric ischemia distal to an old internal carotid artery occlusion in the neck. Fundoscopy and sequential cerebral arteriography documented that recurrent ischemic symptoms in this individual were the result of embolic fragments arising from the stump of the occluded internal carotid artery and from a diseased external carotid artery. These emboli traversed the external carotid artery and its orbital and intracranial anastomotic connections to reach the symptomatic eye and hemisphere. Ischemic symptoms in this patient were effectively terminated with anticoagulant therapy. This patient graphically documents that postocclusion microembolism via the external carotid artery occurs, and probably accounts for postocclusion recurrent ischemica attacks more frequently than is currently appreciated. Recognition of this phenomenon is of importance because of its significant therapeutic implications. In these situations treatment modalities which terminate embolic phenomena would have a more rational basis than do surgical procedures designed primarily to augment collateral blood flow to the symptomatic organ(s).