Manifestations of Stroke

Editor(s): Paciaroni M. (Perugia) 
Agnelli G. (Perugia) 
Caso V. (Perugia) 
Bogousslavsky J. (Montreux) 
Table of Contents
Vol. 30, 2012
Section title: Topographic Syndromes
Paciaroni M, Agnelli G, Caso V, Bogousslavsky J (eds): Manifestations of Stroke. Front Neurol Neurosci. Basel, Karger, 2012, vol 30, pp 185-190

Acute and Chronic Carotid Occlusion Syndromes

Lanari A. · Silvestrelli G.
Stroke Unit, Division of Neurology, Carlo Poma Hospital, Mantova, Italy

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Clinical manifestations of acute internal carotid artery (ICA) occlusion are the most variable among all cerebrovascular syndromes. This extreme variability is related essentially to three variables: collateral circulation, cerebral vasoreactivity with hemodynamic factors, and the characteristics of occlusion. Intracranial circulation is represented by a mirabilis network connecting both anterior-posterior and deep-shallow circulation systems. The compensation mechanisms in ICA occlusion can be influenced by preexisting risk factors. Moreover, an alteration in cerebral hemodynamic function related to previous stroke, chronic hypoperfusion and vascular risk factors play a relevant role in the clinical features of ICA occlusion. On the other hand, also after an acute event, the clinical evolution in a patient with ICA occlusion, which is defined here as chronic occlusion, is extremely variable: some patients remain asymptomatic, while others suffer recurrent TIA or minor/major stroke. The factors set forth above associated with other underlying conditions also affect clinical development. However, a fundamental role is played by the proper management of vascular risk factors whether in acute or chronic ICA occlusion.

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Alessia Lanari, MD, PhD, Stroke Unit, Division of Neurology, Carlo Poma Hospital, Lago Paiolo 10, IT- 46100 Mantova (Italy), Tel. +39 0376 201968, E-Mail

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Number of Print Pages : 6

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Book Serie: Frontiers of Neurology and Neuroscience, Vol. 30, Year 2012

Editor(s): Bogousslavsky, J. (Montreux)
ISSN: 1660-4431 (Print), eISSN: 1662-2804 (Online)

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Book Title: Manifestations of Stroke

Editor(s): Paciaroni M, Agnelli G, Caso V, Bogousslavsky J (eds)

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  1. Pessin MS, Duncan GW, Mohr JP, Poskaner DC: Clinical and angiographic features of carotid transient ischemic attacks. N Engl J Me 1977;296:358-362
  2. Paciaroni M, Viana Baptista M, Bogous-slavsky J: Carotid dissection and carotid occlusion with stroke: neuro-ophthalmological manifestations. Schweiz Arch Neurol Psychiat 1999;150:169-175
  3. (eds) Bogousslavsky J, Caplan L: Stroke Syndrome New York, Cambridge University Press, 1995;
  4. Bogousslavsky J, Regli F, Zografos L, Uske A: Optico-cerebral syndrome: simultaneous hemodynamic infarction of optic nerve and brain. Neurolog 1987;37:263-268
  5. Banford J, Sandercoock P, Dennis M, Burn J, Warlow C: Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lance 1991;337:1521-1526
  6. Liebeskind DS: Collateral circulation. Strok 2003;34:2279-2284
  7. Takahashi S, Tobita M, Takahashi A, Sakamoto K: Retrograde filling of the anterior choroidal artery: vertebral angiographic sign of obstruction in the carotid system. Neuroradiolog 1992;34:504-507
  8. Toyoda K, Minematsu K, Yamaguchi T: Long-term changes in cerebral blood flow according to different types of ischemic stroke. J Neurol Sc 1994;121:222-228
  9. Caplan LR, Hennerici M: Impaired clearance of emboli (washout) is an important link between hypoperfusion, embolism, and ischemic stroke. Arch Neuro 1998;55:1475-1482
  10. Gibbs JM, Wise RJS, Leenders KL, Jones T: Evaluation of cerebral perfusion reserve in patients with carotid-artery occlusion. Lance 1984;1:310-314
  11. Grubb RL, Derdeyn CP, Fritsch MS, Carpenter DA, Yundt KD, Videen TO, Spitznagel EL, Powers WJ: Importance of hemodynamic factors in the prognosis of symptomatic carotid occlusion. JAM 1998;280:1055-1060
  12. Baron JC, Bousser MG, Rey A, Guillard A, Comar D, Castaigne P: Reversal of focal ‘misery-perfusion syndrome’ by extra-intracranial arterial bypass in hemodynamic cerebral ischemia: a case study with 15O positron emission tomography. Strok 1981;12:454-459
  13. Norving B, Nilsson B, Risberg J: rCBF in patients with carotid occlusion: resting and hypercapnic flow related to collateral pattern. Strok 1982;13:155-162
  14. Derdeyn CP, Videen TO, Fritsch SM, Carpenter DA, Grubb RL, Powers WJ: Compensatory mechanisms for chronic cerebral hypoperfusion in patients with carotid occlusion. Strok 1999;30:1019-1024
  15. Coyle P, Panzenbeck MJ: Collateral development after carotid artery occlusion in Fischer 344 rats. Strok 1990;21:316-321
  16. Pessin MS, Hintoc RC, Davis KR, Duncan GW, Roberson GH, Acjerman RH, Mohr JP: Mechanisms of acute carotid stroke. Ann Neuro 1979;6:245-252
  17. Biousse V, D’Anglejan-Chatillon J, Touboul PJ, Amarenco P, Bousser MG: Time course of symptoms in extracranial carotid artery dissections: a series of 80 patients. Strok 1995;26:235-239
  18. Bogousslavssky J, Regli F: Borderzone infarctions distal to internal carotid artery occlusion: prognosis implications. Ann Neuro 1986;20:346-350
  19. Amarenco P, Duyckaerst C, Tzourio C, Henin D, Bousser MG, Hauw JJ: The prevalence of ulcerated plaques in the aortic arch in patients with stroke. N Engl J Me 1992;326:221-225
  20. Paciaroni M, Caso V, Venti M, Milia P, Kappelle LJ, Silvestrelli G, Palmerini F, Acciarresi M, Sebastianelli M, Agnelli G: Outcome in patients with stroke associated with internal carotid artery occlusion. Cerebrovasc Di 2005;20:108-113
  21. Caso V, Paciaroni M, Corea F, Hamam M, Milia P, Pelliccioli GP, Parnetti L, Gallai V: Recanalization of cervical artery dissection: influencing factors and role in neurological outcome. Cerebrovasc Di 2003;17:93-97

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