Emergency internal carotid artery desobliteration in patients with severe neurological deficit.

7 patients evaluated for deep neurological deficit due to internal carotid artery stenosis or occlusion underwent emergency carotid artery desobliteration. At the time of the operation, which was performed 6-10 hours after the onset of signs, all the patients were hemiplegic and, when dominant side affected, aphasic, 5 of them have had the level of consciousness slightly depressed. The patients were divided into two groups: 1. Completed deficit with typical sudden onset of disease, without fluctuation (4 patients). 2. Progressing deficit with rapid downhill course despite medical therapy (3 patients). In the group with completed stroke one patient died, later three experienced modest improvement. In the group with progressing stroke two patients are neurologically intact, the last one in full-activity with mild hemiparesis. It is stated that those with completed stroke are unfavourable candidates for surgery. Patients with progressing stroke should be submitted to surgery before the deficit becomes stabilized.