The impact of occlusion of the internal carotid artery depends upon the effectiveness of compensatory mechanisms, principally, the circle of Willis, and the external carotid which may provide flow to the anterior and the middle cerebral arteries through meningeal branches, and retrogradely through the ophthalmic artery to the internal carotid. Total occlusion may be silent or catastrophic.
Characteristically, the picture is one of a stuttering stroke.
Note that occlusion of the innominate artery from the aortic arch will produce a similar picture but additionally, will reduce blood pressure in the right arm.
Reference
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