Summary
65 consecutive patients with carotid thrombosis have been analyzed and a follow-up study has been possible in 50 cases.
Men have been found to be much more involved than women and the age incidence was the 5th and 6th decades. The onset of the disease was usually of a progressive recurrent type of the attack. Hemiparesis, aphasia, visual disturbance and sometimes headache were among the chief symptoms. Diagnosis was achieved by cerebral angiography, although pneumoencephalogram and electroencephalography might help to confirm the diagnosis and differentiate other conditions. The left side was more affected than the right one and the location of preference seemed to be at the bifurcation and to lesser extent at the carotid siphon. Most of the involved vessels were affected with thrombo-angiitis obliterans, while arteriosclerosis and other indefinite causes were found in smaller proportions. The prognosis is unfavorable, about 34% of the patients expired before 5 years and from those who are still living, more than half are invalid.
Zusammenfassung
Bei 65 Kranken mit Thrombose der Karotis war es möglich, eine Nachprüfung in 50 Fällen vorzunehmen. Es ergab sich, daß Männer öfter als Frauen befallen werden und das betreffende Alter ist in der 5. und 6. Dekade. Der Anfang der Krankheit offenbart sich gewöhnlich durch fortlaufend wiederholte Anfälle. Hemiparese, Aphasie, Gesichtsfeldstörungen und zuweilen Kopfschmerzen sind unter den Hauptsymptomen. Die Diagnose wird auf Grund von Gehirnangiogrammen erreicht: dennoch können Pneumoencephalogramme und Elektroencephalographien für die Feststellung der Diagnose und bei Unterscheidung anderer Symptome von Hilfe sein. Die linke Seite wird öfter betroffen als die rechte und der bevorzugte Sitz scheint an der Gabelung und in geringerem Ausmaß am Siphon der Karotis zu sein. Die Mehrzahl der betroffenen Gefäße war von der Winiwarter-Bürgerschen Krankheit befallen, während Arterienverkalkung und andere unbestimmte Ursachen in geringerem Umfang festgestellt wurden. Die Prognose ist ungünstig, denn 34% der Kranken starb vor Ablauf von 5 Jahren, und unter den noch lebenden sind mehr als die Hälfte Invaliden.
Résumé
65 malades présentant une thrombose de la carotide ont été examinés et dans 50 cas on a pu effectuer un contróle après un certain laps de temps. On a pu constater que l'homme est atteint plus fréquemment que la femme et la maladie se manifeste principalement entre la cinquantaine et la soixantaine. Le début de la maladie se manifeste généralement avec des épisodes périodiques progressifs. Parmi les principaux symptômes on trouve l'hémiparalysie, l'aphasie, des troubles visuels et parfois céphalée.
Le diagnostic fut établi en se basant sur l'angiographie cérébrale; toutefois la pneumoencéphalographie et l'électroencéphalographie pourraient contribuer à confirmer le diagnostic et à différencier d'autres conditions. Le côté gauche du corps est frappé plus fréquemment que le côté droit et le siège d'élection semble être à la bifurcation et, mais moins souvent, au siphon carotidien. La plus grande partie des vases atteints était frappé par un processus de thrombo-angéite oblitérante, tandis que l'artériosclérose et d'autres causes indéfinies se trouvent en proportions mineures. Le prognostique est défavorable: le 34% environ des malades décédait dans les 5 ans qui suivaient et parmi ceux qui sont encore en vie, plus de la moitié sont impotents.
Riassunto
Sono stati analizzati 65 malati con trombosi della carotide e in 50 casi è stato possibile fare un controllo a distanza di tempo. Si è potuto constatare che l'uomo è più frequentemente colpito della donna e il decennio di maggior frequenza è il 50 e il 60. L'inizio della malattia si manifesta generalmente con episodi periodici progressivi. Tra i sintomi principali si riscontrano emiparesi, afasia, disturbi visivi e talvolta cefalea. La diagnosi fu stabilita in base all'angiografia cerebrale; tuttavia la pneumoencefalografia e l'elettroencefalografia potrebbero contribuire a confermare la diagnosi e a differenziare altre condizioni. Il lato sinistro è più frequentemente colpito di quello di destra e la sede di elezione sembra essere alla biforcazione, e in grado minore al sifone carotideo. La maggior parte dei vasi compromessi era colpita da un processo di tromboangioite obliterante mentre l'arteriosclerosi ed altre cause indefinite si trovano in proporzioni minori. La prognosi è sfavorevole: circa il 34% dei malati decedeva entro 5 anni e tra quelli ancora in vita più della metà sono invalidi.
Resumen
Han sido analizados 65 enfermos con trombosis de la carótida y en 50 casos ha sido posible, después de un cierto tiempo, hacer una verificación. Se ha podido constatar que el hombre es mas frecuentemente alcanzado de la mujer y que los diez años de mayor frecuencia de la enfermedad son los entre los 50 y los 60. El principio de la enfermedad se manifiesta en general con episodios periodicos progressivos. Entre los principales síntomas que se notan hay la hemiparesis, molestias visuales y algunas veces cefalea. El diagnóstico fué hecho en base de la angiografía cerebral; sin embargo la pneumoencefalografía y la electroencefalografía podrían contribuir a confermar el diagnóstico y a diferenciar otras condiciones. El lado izquierdo es mas frecuentemente alcanzado del derecho y el sitio de elección parece ser a la bifurcación, y al sifón carotideo, este ultimo en grado menor. Casi todos los vasos comprometidos era alcanzados por un proceso de tromboangioitis obliterante, mientras, en menor proporción, se encuentran la arteriosclerosis y otros motivos indefinidos. El pronóstico es desfavorable: cerca el 34% de los enfermos muriéron en los 5 años y entre los que aun viven, mas de la mitad son invalidos.
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Sastrasin, K. Carotid thrombosis. An evaluation and follow-up study of 65 cases. Acta neurochir 5, 11–37 (1957). https://doi.org/10.1007/BF01414990
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DOI: https://doi.org/10.1007/BF01414990