Clinical Study of Carotid Occlusive Disease

Lee, Sun Ho; Kim, Hyun Jib; Han, Dae Hee; Noh, Jai Kyu; Myung, Ho Jin; Choi, Kil Soo

Abstract

The authors analyzed the stroke patients admitted to department of neurosurgery and neurology of Seoul National University Hospital between 1980 and 1987. Among the 883 ischemic stroke patients angiography was performed in 158 cases. Twenty-two cases of atherosclerotic carotid occlusive disease were detected. The peak incidence of carotid occlusive disease was in the 6th decade and sex ratio of male to female was 2.7:1. Most of patients had a long history of repeated ischemic attacks and the common symptoms and signs on admission were motor weakness, speech disturbance, sensory change and visual disturbance. The associated diseases were hypertension(40.9%), hyperlipidemia(31.8%), hyperuricemia(27.3%), dysarhythmia(22.7%), heart disease(27.2%) and diabetes mellitus(13.6). CT findings showed lesions on the middle cerebral artery(MCA) territory most frequently(40.9%) then watershed zone infarct(18.2%) and diffuse brain atrophy(18.2%). Angiographic findings showed multiple lesions in 50% and lesion sites were proximal internal carotid artery(ICA) in 51.9% then cavernous portion, supraclinoid portion, petrosal portion and extracranial distal ICA in order of frequency. Clinical outcomes after the medical or surgical treatment were improved in 45.5%, stable in 45.5% and late worsening in 9.1%.