Internal carotid occlusion: volume of cerebral infarction, clinical findings, and prognosis.

Clinical, angiographic and computed tomographic (CT) findings, and the volume of an infarcted area as estimated from tomograms, were evaluated in 26 patients with proven, unilateral, internal carotid artery (ICA) occlusion. The volume of cerebral infarction (CI) ranged from 0 cm3 to 200 cm3. It was shown that the CI volume in the group of patients with good collateral flow was smaller than that in the group with poor or no collaterals (p less than 0.05). It was also found that the smaller the volume of infarcted area, the better the patient's ability to carry out activities of daily living (ADL). The volume of infarction in patients without disturbance of consciousness was smaller than in patients with such disturbance. Thirteen of 15 patients with infarction of less than 50 cm3 eventually showed good ADL. The patients with a deeply located infarction had a good prognosis and no disturbance of consciousness. In patients with superficial infarction there were relationship between the volume of infarction and prognosis, and between the volume and disturbance of consciousness. It is concluded that estimation of the volume of an infarcted area is important in assessing the clinical state and prognosis in patients with ICA occlusion.