Pseudo-tandem stenosis of the internal carotid artery

Two cases of pseudo-tandem stenosis of the internal carotid artery are presented. Proximal stenosis was produced by a large, focal atherosclerotic plaque. The severe intracranial "stenosis" was thought to be an angiographic artifact. Repeat cerebral angiography after carotid endarterectomy revealed normal intracranial arteries. The recognition of this entity is important because a decision to operate is based largely upon angiographic findings.