Small strokes in the carotid territory associated with a normal carotid arteriogram

Appropriate percutaneous carotid arteriography was carried out in 69 patients who presented with transient ischaemic attacks (TIAs) in the carotid territory. Major abnormalities were detected in 19 which included internal carotid stenosis (nine), internal carotid occlusion (seven), intracranial aneurysm (two), and cerebral angioma (one). Forty-five patients had normal angiograms and five slight irregularity of the internal carotid artery without stenosis. The symptoms and signs pertaining to the normotensive and hypertensive groups are presented. The outcome of stroke in 35 normotensives was as follows: three died of related disease, three are severely disabled, two have slight disability, eight have minor neurological residua, and 19 are normal. Fifteen patients had a diastolic blood pressure of above 105 mm Hg and the outcome of stroke in these patients treated with hypotensive agents was as follows: two died of related disease, two have severe and two moderate disablement, four have slight disability, one has minor residua, and four are normal. The pathogenesis of TIAs in relation to the two groups and the use of anticoagulant drugs and hypotensive agents are discussed.