History of Carotid Stroke

Extracranial-intracranial bypass approach to cerebral revascularization: a historical perspective

“…2 Neurovascular imaging allowed for the visual confirmation of several pathologic processes, including the link between carotid occlusion and cerebral infarction, as described by Hans Chiari in 1905. 33 In 1951, Miller Fisher (1913 not only confirmed Chiari's work but also was able to define the varying degrees of carotid stenosis and their clinical consequences, including "transient global amnesia," "ocular bobbing," "wrong-way eyes," "string sign," and more. 32 He believed that a surgical solution to the identified pathology was feasible and famously stated, "It is even conceivable that some day vascular surgery will find a way to by-pass the occluded portion of the artery during the period of ominous fleeting symptoms."…”

“…25 In 1754, less than a century after Willis' discovery, Gerhard van Swieten suggested that debris originating in the heart could break off and become lodged in distal arteries and result in apoplexy, the first proposed mechanism for cerebral embolism and stroke. 33 Although significant progress was made in vascular anatomy and physiology, surgeons of the time period continued to employ the same cauterization techniques used by their predecessors to treat wounds, particularly from gunshots. French battlefield surgeon Ambroise Paré shifted the focus back toward the Galen teaching of ligature in 1564 by reporting better outcomes in comparison to cauterization in one of the first surgical clinical trials.…”

The Rheology of the Carotid Sinus: A Path Toward Bioinspired Intervention

“…(The Greek word for “stupefy”, “karos”, provides the basis for our modern “carotid.”). Indeed, Rufus of Ephesus, circa 50 AD, described the almost immediate change in blood flow and mentation when the vessels in the neck were compressed ( Munster et al, 2016 ). For the 1,800 years that ensued, the notion that there was a profound slowing of the heart rate with compression of the neck vessels was attributed, somewhat correctly, to the nerves adjacent to the carotid ( Glick and Covell, 1968 ; Persson and Kirchheim, 1991 ).…”

Should We Ever Pace for Carotid Sinus Syndrome?

“…The ancient Assyrians used carotid compression to dull the pain associated with ritual circumcision (1), while one of the Parthenon's metopes from the 5th century BC illustrates the offensive use of carotid compression by a centaur to cause unconsciousness in an opposing Lapith soldier (Figure 1). Six centuries later, the ancient Greek physician and philosopher Galen (AD c 130-210) wrote of the loss of consciousness caused by the compression of nerves surrounding the carotid arteries (2), while the Greek recognition of the physiologic significance of the carotids is evident, the name being derived from the Greek karotides, the plural of karotis, meaning drowsiness, which itself was derived from the verb karoun (to stupefy). The Persian Muslim father of modern medicine Avicenna (c 980-1037; Figure 2) later commented on falling and unconsciousness induced by carotid sinus pressure by hammams in public baths (3,4), while the French barber surgeon to several kings Ambroise Paré (c 1510-1590) noted that "(the) two branches which they call carotides or soporales, the sleepy arteries, because they being obstructed, or any way stopt we presently fall asleep" (5).…”