21 patients with intracranial obstruction of an internal carotid artery (ICA) (15 stenoses, 6 occlusions) were studied for angiographic, clinical and prognostic evaluation. Evidence of atheromatous changes and associated risk factors did not significantly differ from age- and sex-matched controls with extracranial ICA disease. No significant difference occurred between matched groups with extra- or intracranial ICA obstruction in functional outcome, delayed strokes, TIAs and death, suggesting that prognosis was more related to age, sex and degree of obstruction than to level of obstruction. 80 intracranial stenosis patients had the worst functional outcome, 30–60 stenosis patients the best, and occlusion patients were intermediate. This corresponded to higher risk of delayed stroke in patients with 80 stenosis. The prognosis was better in patients without evidence of proximal atheromatosis. Only 1 patient with intracranial occlusion suffered delayed homolateral TIAs in which atheromatous embolization from stenosed contralateral ICA was hypothetize
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