Occlusive Vascular Disease in the Extracranial Cerebral Circulation

Abstract

Although there have been many studies of the clinical aspects of occlusive vascular disease in the extracranial carotid and vertebral arteries, studies of the pathology of these arteries have been few and have usually been confined to the carotid system. The true incidence of disease in these arteries has not been established. Reasons for the lack of studies of the arteries supplying blood to the brain are twofold; namely, removal of the carotid and vertebral arteries has been considered technically difficult, and, until recently, both clinicians and pathologists have been unaware of the high incidence of atherosclerotic narrowing in these vessels. <h3>Review of the Literature</h3> The possible role of cervical carotid-artery disease in the causation of vascular lesions of the brain was suggested by Hunt¹in 1914. He examined 20 patients with hemiplegia and found a diminished carotid pulse on the appropriate side in 4. He called attention to