Abstract
A 71-year-old man was admitted to our neurological service due to clouding of consciousness and right-sided weakness. Neurological examinations on admission revealed a semicomatous state, tetraplegia and bilateral pyramidal tract signs. The computed tomographic (CT) findings demonstrated bilateral infarctions of the anterior cerebral artery territory. Cerebral angiography revealed bilateral occlusion of the internal carotid artery, and a well-developed collateral circulation. The bilateral anterior cerebral artery was recognized via anastomosis from a branch of the left external carotid artery. The infarction in this patient resulted from artery-to-artery embolism from the distal part of the left internal carotid artery. The pathogenesis of bilateral internal carotid artery occlusion is discussed with special reference to the blood supply of the anterior cerebral artery.
