1. Thrombotic Occlusion of the Common Carotid Artery in Acute Ischemic Stroke Vijay K Sharma Consultant Neurologist National University Hospital Singapore [email_address]

7. Clinical, imaging, sonographic characteristics with recanalization patterns, neurological recovery and disposition data of the three cases with acute CCA occlusions Sharma VK et al. Eur J Neurol 2007;14:237-240

8. Case 1- Sonographic and imaging findings Acute mobile thrombi on transverse (a) and longitudinal (b) views on B-mode cervical duplex sonography. Computerized tomographic (c) of neck showing non-opacification (arrows) of right CCA. Final cerebral infarctions seen on diffusion weighted MRI (d) Note the thrombus in ICA also (b). Schematic representation of CCA occlusion & intracranial flow patterns..Note anterior cross-filling of ipsilateral MCA via ACOM and flow reversal in ipsilateral ACA. 1- Aortic arch; 2-Innominate artery; 3- CCA; 4- ECA; 5-ICA; 6-Subclavian artery; 7-Veretbral artery; 8- intracranial ICA; 9-A1 segments of ACA; 10-M1 segments of MCA; 11-A2 segments of ACA; 12-Anterior communicating artery; 13-Ophthalmic artery; 14-Basilar artery.

9. Case 2- Sonographic and imaging findings Acute mobile thrombi on transverse (a) and longitudinal (b) views on B-mode cervical duplex sonography. s CT angiogram of neck (c) showing non-opacification of left CCA. Final cerebral infarctions seen on brain CT scan (d). 1- Aortic arch; 2-Innominate artery; 3- CCA; 4- ECA; 5-ICA; 6-Subclavian artery; 7-Veretbral artery; 8- intracranial ICA; 9-A1 segments of ACA; 10-M1 segments of MCA; 11-A2 segments of ACA; 12-Anterior communicating artery; 13-Ophthalmic artery; 14-Basilar artery. Schematic representation of CCA occlusion and intracranial flow patterns. It shows thrombotic occlusion of left CCA, ICA, ECA,intracranial ICA, ipsilateral MCA and ACA. No intracranial collateral flow is seen.

10. Case 3- Sonographic and imaging findings Acute mobile thrombi on transverse (a) and longitudinal (b) views on B-mode cervical duplex sonography. Digital subtraction angiograms (c) of neck showing non-opacification of right CCA. Final cerebral infarctions seen on diffusion weighted MRI (d) Schematic representation of CCA occlusion and intracranial flow patterns. Thrombotic occlusion of right CCA, ECA, ECA and intracranial ICA with anterior cross-filling of ipsilateral MCA via ACOM and flow reversal in ipsilateral ACA. 1- Aortic arch; 2-Innominate artery; 3- CCA; 4- ECA; 5-ICA; 6-Subclavian artery; 7-Veretbral artery; 8- intracranial ICA; 9-A1 segments of ACA; 10-M1 segments of MCA; 11-A2 segments of ACA; 12-Anterior communicating artery; 13-Ophthalmic artery; 14-Basilar artery.