No post mortem examination on a patient who has died as a result of a stroke, or who has a history of a previous stroke, is complete unless the major extracranial cerebral arteries, viz. the internal carotid and the vertebral arteries in the neck, are examined since cerebral infarction may be caused or contributed to by occlusion or stenosis of one of these arteries. They can be opened in situ but this does not really allow of an assessment of the severity of stenosis or the extent of any occlusion by thrombus. By far the best method is to dissect out the principal arteries and then to examine them after preliminary fixation. This dissection should be undertaken before removing the central structures of the neck, viz. the pharynx, larynx etc.

Fig. 5.1 Access to the arteries is greatly facilitated by using a “collar” incision when opening the body, and then reflecting the skin to expose the lateral structures in the neck.

Figs. 5.2 and 5.3 The sternomastoid muscle (arrow in Fig. 5.2) is retracted laterally to expose the common carotid artery (arrow in Fig. 5.3).