23497              THROMBOSIS OF LEFT INTERNAL CAROTID ARTERY

The patient was a man aged 58 who had been hypertensive for some years and had had an episode of congestive cardiac failure. He was a heavy drinker. On admission he was unconscious; the pulse was 80 and irregular, the B.P. 210/110 with a loud systolic murmur. There was a right upper motor neurone paralysis of the 7th nerve and the eyes were deviated to the left. He remained unconscious and died on the 4th day. At postmortem there was an extensive softening in the territories of the left middle and anterior cerebral arteries, sparing the inferior temporal gyrus and the occipital lobe.

The specimen shows the common carotid artery with its bifurcation into internal and external carotid arteries. There is soft tissue between these branches. The proximal 2 cm of the internal carotid artery contains antemortem thrombus which has occluded its lumen. There is little obvious underlying atherosclerosis of the carotid vessels.