Abstract
We report two patients who underwent cervical carotid ligation, without a revascularization procedure, for internal carotid aneurysms, focusing on various neuro-imaging findings obtained 14 and 11 years after ligation, respectively. Magnetic resonance (MR) angiography and digital subtraction angiography showed disappearance of the original aneurysms and no “de novo” aneurysm formation. MR imaging and computed tomographic (CT) scan demonstrated the aneurysms to be thrombosed. No major ischemic lesions were detectable in the cerebral parenchyma by means of MR imaging, stable xenon/CT cerebral blood flow, dynamic CT scan and single photon emission CT. Serial thin slice, bone window CT scans demonstrated that no changes in the caliber of the bony carotid canal may be produced by acquired hypoplasia of the internal carotid artery. These extensive neuro-imaging follow-up studies appear to be essential for proper evaluation of the long-term benefits, as well as potential untoward effects, of cervical carotid occlusion.
