The ancient Greeks used the term karotides for the great arteries in the neck, compression of which could plunge the victim into karoun: deep sleep or stupor. The artery name aside, studies of the patterns of brain infarction and their clinical severity have been an unbroken chain of growing sophistication in the past 150 years. Two main patterns emerged: perfusion failure with high-convexity infarction from hemodynamically important ipsilateral carotid stenosis or embolism from nonstenosing carotid plaque.