Acta Medica Iranica 2017. 55(11):718-721.

Whole Cerebral Blood Flow Originating From Vertebral Arteries After Bilateral Internal Carotid Arteries Occlusion: A Case Report
Ahmad Pour Rashidi, Saeed Saeedinia, Mohammad Shiran, Kourosh Karimi Yarandi, Maysam Alimohamadi


Bilateral occlusion of internal carotid arteries is a rare condition usually associated with severe neurological symptoms. It is very uncommon finding among patients with ischemic stroke. In this article, we report a rare case of bilateral occlusion of internal carotid artery who presented with mild reversible neurological symptoms. Angiographic evaluation of her cerebral vasculature revealed no flow across the both cervical internal carotid arteries, but a run off through both posterior communicating arteries from the vertebrobasilar system. We performed a review of the pertinent literature and discussed different management option in these patients.


Cerebrovascular; Carotid occlusion; Stroke

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Levine SR, Welch KM. Common carotid artery occlusion. Neurology 1989;39:178-86.

Zhilin X, Xueying L, Wei B, Wenxian L, Zhen J, Li’an H. Bilateral Atherosclerotic Internal Carotid Artery Occlusion with Intact Cerebral Glucose Metabolism: A Case Report. J Stroke Cerebrovasc Dis 2015;24:201-4.

Chang YJ, Lin SK, Ryu SJ, Wai YY. Common carotid artery occlusion: evaluation with Duplex Sonography. Am J Neuroradiol 1995;116:1099-105.

Shiao-Lin L, Yi-Chun C, Hsu-Huei W, Sien-Tsong C, Shih-Pin H, Tsong-Hai L. Bilateral common carotid artery occlusion — A case report and literature review. J Neurol Sci 2005;238:101-4.

AbuRahma AF, Copeland SE. Bilateral internal carotid artery occlusion; natural history and surgical alternatives. Cardiovasc Surg 1998;6:579-83.

Wade JP, Wong W, Barnett HJ, Vandervoort P. Bilateral occlusion of the internal carotid arteries. Presenting symptoms in 74 patients and a prospective study of 34 medically treated patients. Brain 1987;110:667-82.

Fields WS, Lemak NA. Joint study of extracranial arterial occlusion. J Am Med Assoc 1976;235:2734-8.

Nicholls SC, Kohler TR, Bergelin RO, Primozich JF, Lawrence RL, Strandness DE. Carotid artery occlusion: natural history. J Vasc Surg 1986;4:479-85.

Faught WE, Van Bemmelen PS, Mattos MA, Hodgson KJ, Barkmeier LD, Ramsey DE, et al. Presentation and natural history of internal carotid artery occlusion. J Vasc Surg 1993;18:512-24.

Alurkar A, Karanam LS, Oak S, Dange N. Endovascular treatment of ruptured wide-necked-basilar tip aneurysm with Y stenting and coiling in a case of bilateral internal carotid artery occlusion with moyamoya disease. Neurol India 2012;60:449-50.

Yoshida S, Eguchi K, Onodera K, Suzuki K, Fujishiro K, Riku S. Bilateral internal carotid artery occlusion and severe basilar artery stenosis in a patient with fibromuscular dysplasia: a case report. Rinsho Shinkeigaku 2013;53:439-45.

Prefasi D, Martínez-Sánchez P, Fuentes B, Díez-Tejedor E. Bilateral carotid occlusion and progressive stenosis of vertebral arteries after radiotherapy in a young patient. Neurologia 2012;27:122-4.

Xu K, Wang H, Luo Q, Li Y, Yu J. Endovascular treatment of bilateral carotid artery occlusion with concurrent basilar apex aneurysm: a case report and literature review. Int J Med Sci 2011;8:263-9.

Hayashi K, Horie N, Suyama K, Nagata I. An epidemiological survey of moyamoya disease, unilateral moyamoya disease and quasi-moyamoya disease in Japan. Clin Neurol Neurosurg 2013;115:930-3.

Kim SS, Park DH, Lee NJ, Kang SH, Lim DJ, Chung YG. Coil embolization of a ruptured basilar tip aneurysm associated with bilateral cervical internal carotid artery

occlusion: a case report and literature review. J Cerebrovasc Endovasc Neurosurg 2012;14:44-9.

Rabinstein AA, Romano JG, Forteza AM, Koch S. Rapidly progressive dementia due to bilateral internal carotid artery occlusion with infarction of the total length of the corpus callosum. J Neuroimaging 2004;14:176-9.

Persoon S, Klijn CJ, Algra A, Kappelle LJ. Bilateral carotid artery occlusion with transient or moderately disabling ischaemic stroke: clinical features and long-term outcome. J Neurol 2009;256:1728-35.

Powers WJ, Derdeyn CP, Fritsch SM. Benign prognosis of never-symptomatic carotid occlusion. Neurology 2000;54:878-82.

Lai SL, Chen YC, Weng HH, Chen ST, Hsu SP, Lee TH. Bilateral common carotid artery occlusion–a case report and literature review. J Neurol Sci 2005;238:101-4.

Marshall RS, Festa JR, Cheung YK, Pavol MA, Derdeyn CP, Clarke WR, et al, RECON Investigators. Randomized Evaluation of Carotid Occlusion and Neurocognition (RECON) trial: main results. Neurology 2014;82:744-51.

Romero JR, Pikula A, Nguyen TN, Nien YL, Norbash A, Babikian VL. Cerebral collateral circulation in carotid artery disease. Curr Cardiol Rev 2009;5:279-88.


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