The Diseases Showing the Abnormal Cerebrovascular Network at the Base of the Brain with Occlusion of the Internal Carotid Arteries

ABSTRACT

Japanese neurosurgeons have recently reported number of disorder having typical angiographic findings, which showed abnormal cerebrovascular network at the base of the brain related with the occlusion of the internal carotid arteries in Japanese race. Since the authors have observed five cases of the similar vascular abnormalities in Korea by cerebral angiography from 1969 to 1971, the clinical findings and angiographic features of these cases were presented. The results were summarized as follows; 1. Of the 5 patients, 4 cases were over 20 years of age and one 5-year-old child. 4 cases were male and one female. 2. There were considerable differences in the initial symptoms of these patients. Authors classified these as the group of subarachnoidal hemorrhage and non-subarachnoidal hemorrhage. The former was 3 cases and later 2. The most frequent clinical manifestations in the hemorrhagic group was headache, impairment of consciousness and sings of meningeal irritation, while hemiparesis and speech disturbance was mainly seen in the nonhemorrhagic group. Similar clinical pictures were reported in Japanese cases. 3. Characteristic cerebral angiographic findings of these cases were; 1) Narrowing of the cervical portion of both internal carotid arteries. 2) Occlusion or stenosis of bilateral internal carotid arteries at the supraclinoid portion. 3) Abnormal vascular network at the base of the brain around the occlusive area. 4) Anterior and middle cerebral arteries were no visualized in all cases and superficial temporal arteries or ophthaemic artery was prominent in a few cases. The etiological possibility of these disorder, radiological features and symptomatology were discussed.