Bilateral chronic common carotid occlusion

Case contributed by Chris O'Donnell


Increasing confusion but no focal neurological deficit

Patient Data

Age: 80
Gender: Male

Hypertrophied vertebral arteries with occlusion of both common carotids at their origins,  Intracranial arteries (MCA and ACA) are filling normally being supplied by a dominant right posterior communicating artery.  Note external carotid branches are patent being fed by vertebral and subclavian branch collaterals.

Case Discussion

If arterial occlusion occurs over a prolonged period, collaterals can develop.  In this case external carotid branches have remained patent and intracranial arteries are being fed by a well developed circle of Willis.

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