Delayed cerebral ischemic episodes distal to occlusion of major cerebral arteries

Neurology. 1978 Aug;28(8):769-74. doi: 10.1212/wnl.28.8.769.


Some time after deletion of occlusion of the appropriate artery, 20 patients had transient ischemic attacks and seven had strokes. The common statement that transient ischemic attacks cease when an artery becomes occluded must, therefore, be modified. Seventeen of the 20 patients reported here developed symptoms weeks to years after the appropriate artery was known to be occluded, while 10 attacks occurred within 1 week after occlusion. Embolism through collateral circulation probably accounts for the delayed ischemic events in most of the patients, and hemodynamic factors in a few. The stump of the occluded artery may be the site of atheromatous ulceration. The possibility of revascularization procedures for patients with occluded arteries makes pertinent these observations about potential embolic sources.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Arterial Occlusive Diseases / complications*
  • Arterial Occlusive Diseases / diagnostic imaging
  • Carotid Arteries / surgery
  • Cerebral Angiography / adverse effects
  • Cerebral Arterial Diseases / complications*
  • Cerebral Arterial Diseases / diagnostic imaging
  • Female
  • Humans
  • Intracranial Embolism and Thrombosis / complications
  • Ischemic Attack, Transient / diagnostic imaging
  • Ischemic Attack, Transient / etiology*
  • Ligation
  • Male
  • Middle Aged
  • Postoperative Complications
  • Time Factors