Carotid endarterectomy (CEA) has been shown to decrease the long-term risk of stroke compared with medical therapy. Percutaneous techniques such as carotid artery angioplasty with stenting (CAS) are less invasive and a viable option for the treatment of carotid artery…
Diabetes mellitus (DM) has been described as an epidemic in progress. By 2050 its prevalence among adults in the United States is predicted to increase from 1 in 10 to 1 in 5. Additionally, in the adolescent population its incidence…
Despite expanding research and advancements in medical care, there are approximately 610,000 new first-attack strokes in the United States every year, resulting in nearly 136,000 deaths and adding to the total of 6.4 million Americans as stroke survivors. Of all…
The distinction between a transient ischemic attack (TIA) and stroke is made by duration of symptoms: The duration of a TIA is less than 24 hours. A TIA is a harbinger of stroke in up to 17% of patients, most…
Transcranial Doppler (TCD) ultrasonography is the only noninvasive real-time examination that adds important physiologic information to anatomic imaging studies when evaluating blood flow in major intracerebral vessels. It is considered an extension of the clinical neurologic examination, which includes ultrasound…
In the 1980s and 1990s, grading of the degree of internal carotid artery (ICA) stenosis with duplex scanning depended on Doppler velocities at the site of maximum stenosis. With increasing resolution and image quality of gray-scale images and better color…
The evolution of diagnostic tools available to study cerebrovascular disease has advanced in recent years. Although some of the major tests aid in identifying occlusive or aneurysmal disease, especially in patients with contraindications to standard contrast studies, the newest techniques…
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Catheter-based angiography is considered the gold standard for imaging the cerebral vasculature. The first report of x-ray angiography of vasculature was in 1896, performed in Vienna on a cadaveric specimen. The field has progressed dramatically since that time, with many…
Giant cell arteritis (GCA), also called temporal arteritis, is characterized by granulomatous inflammation of large arteries. Although GCA predominantly involves the extracranial branches of the carotid artery, the aorta and its major branches can also be affected. GCA is a…