Weakness of the lower extremity in carotid occlusive disease
T. Yanagihara, T. M. Sundt Jr and D. G. Piepgras
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Nineteen patients experienced progressive or episodic weakness of one lower
extremity caused by severe stenosis or occlusion of the internal carotid
artery. The majority of patients (84.2%) had occlusion or severe stenosis
at the origin. Based on clinical profiles, angiographic findings, and
cerebral blood flow patterns, we concluded that the pathophysiologic
mechanism was hypoperfusion in the border zone between the anterior
cerebral artery and the middle cerebral artery and that patients with
progressive weakness had more extensive compromise in cerebral circulation.
Following surgical treatment in 17 patients, progressive and episodic
weakness disappeared and the majority of them (76.4%) became asymptomatic.
However, the patients with stenosis at the siphon and those with
progressive weakness from occlusion at the origin appeared to be at
increased risk for cardiac death.
