In 80 patients with unilateral carotid artery occlusions who had neurological symptoms, course and prognosis without anticoagulant or surgical therapy were analyzed. 17.5% of these patients died within 4 weeks, 43% of this group from extracerebral complications. The survival-time of those patients, surviving the acute stage, was also shortened: one year later only 67% of the patients were still alive, 5 years later 58% and after 10 years only 42%. Many cases died from further cerebrovascular strokes. In most of the patients carotid artery occlusion is only one of the symptoms of a generalized artery disease, i.e. arteriosclerosis. Resulting poor collateral circulation may be the crucial factor leading to the poor prognosis as to survival and rehabilitation: only 3.8% of the patients returned to work, 19% are able to walk, and 55% need nursing. These facts demand prophylactic measures: first a decisive therapy with respect to the risk factors of stroke, second an alertness to transitory ischemic attacks or small strokes. The latter were found in 56% of our patients. The literature and value of different therapeutic measures will be discussed.
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