LaMuraglia G M, Darling R C, Brewster D C, Abbott W M
Arch Surg. 1987 Apr;122(4):432-5. doi: 10.1001/archsurg.1987.01400160058008.
A retrospective review of the clinical course surrounding internal carotid artery occlusion (ICO) was undertaken in 97 patients with 106 instances of ICO. No neurologic symptoms could be attributed to more than half of the ICOs. Of the 52 symptomatic occlusions, 19 (37%) were associated with transient ischemic attacks and 33 (63%) with fixed strokes. Only 10% of all patients had permanent disabling neurologic sequelae. There was no correlation between development of neurologic symptoms and the side of the ICO, the presence or severity of contralateral carotid artery disease, or other risk factors. Women, however, were twice as likely as men to develop a fixed stroke with ICO. Seventy-six of these patients underwent reconstructive carotid surgery. Although there was a high rate of abnormal intraoperative findings with electroencephalographic monitoring (32 of 62 cases), with the use of intraoperative shunts there was no increase in the postoperative stroke complication rate (1.8%). These data suggest that the concern that ICO leads to serious fixed neurologic deficits may be overestimated, and that its presence does not adversely affect carefully performed contralateral carotid endarterectomy.
对97例出现106次颈内动脉闭塞（ICO）的患者的临床病程进行了回顾性研究。超过半数的ICO未引发神经症状。在52例有症状的闭塞中，19例（37%）与短暂性脑缺血发作相关，33例（63%）与固定性卒中相关。所有患者中仅有10%出现永久性致残性神经后遗症。神经症状的出现与ICO的侧别、对侧颈动脉疾病的存在或严重程度以及其他危险因素之间均无相关性。然而，女性因ICO发生固定性卒中的可能性是男性的两倍。其中76例患者接受了颈动脉重建手术。尽管术中脑电图监测发现异常的比例较高（62例中有32例），但使用术中分流装置后，术后卒中并发症发生率并未增加（1.8%）。这些数据表明，对ICO会导致严重固定性神经功能缺损的担忧可能被高估了，而且ICO的存在并不会对仔细实施的对侧颈动脉内膜切除术产生不利影响。
