The neuronal damages and the changes in central acetylcholine (ACh) and choline (Ch) contents following permanent occlusion of bilateral common carotid arteries (2VO) of rats were investigated 1 and 4 months after the operation. Two types of neuronal damages were observed in the rats with permanent 2VO. The first type was the infarctions observed in the cerebral cortex and striatum. The infarction in the cortex and striatum was observed in 28.6 and 42.9% of the animals examined 1 month after permanent 2VO, respectively. These ratios did not change even when examined 4 months after permanent 2VO, suggesting that this type of neuronal damage is due to acute ischemic attacks. The second type was progressive neuronal damages observed in the hippocampus and white matter: the neuronal loss in the CA1 subfield appeared 4 months but not 1 month after permanent 2VO and the rarefaction of white matter which was observed 1 months after permanent 2VO and markedly increased 4 months after the operation. Moreover, ACh level significantly decreased in the striatum but not in the cortex, hippocampus or hypothalamus 1 month after permanent 2VO, while the ACh levels in the cortex, striatum and hypothalamus, and Ch levels in all the regions tested significantly decreased when tested 4 months after the operation. These changes did not accompany necrosis. These results suggest that the progressive neuronal degeneration and cholinergic dysfunction following the permanent 2VO are in part involved in chronic cerebral hypoperfusion-induced long-lasting cognition deficits in rats.