clinical features
Last reviewed 01/2018
Typically, progressive obliteration of the lumen of the internal carotid artery by atheroma and thrombus produces the picture of a 'stuttering' stroke characterised by:
- progressing contralateral hemiparesis and hemisensory disturbance
- transient ipsilateral visual impairment due to retinal ischaemia
- unilateral frontal headache
In more extreme cases, there is additionally:
- deterioration of consciousness
- homonymous hemianopia of the contralateral side
- partial Horner's syndrome on the ipsilateral side
- global aphasia if the dominant hemisphere is affected
On examination:
- bruit at the angle of the jaw
- facial and scalp pulses more prominent on the affected side; become impalpable if total occlusion develops