By Professor Dr. Gianni Boris Bradač, Priv.-Doz. Dr. Roland Oberson (auth.)
In this age once we are witnessing a veritable explosion in new modalities in diagnos tic imaging we proceed to have a good want for particular reviews of the vascularity of the mind in sufferers who've all kinds of cerebral vascular disorder. a lot of the knowledge of cerebral vascular occlusive lesions which we built within the final twenty years used to be in accordance with our skill to illustrate the vessels that have been affected. a lot experimental paintings in animals have been performed the place significant cerebral vessels have been obstructed and the results of those obstructions at the mind saw pathologically. despite the fact that, it used to be no longer until eventually cerebral angiography may be played with the element that turned attainable within the many years of the '60 's and for that reason that lets start to comprehend the connection of the obstructed vessels saw angiographically to the medical findings. additionally, a lot physiologic details was once got. for example, the idea that ofluxury perfusion that's used to explain non-nutritional stream during the tissues used to be saw first angiographically even if the time period used to be no longer used till LASSEN defined it as a pathophysiological phenomenon saw in the course of cerebral blood movement stories with radioactive isotopes. the idea that of embolic occlusions of the cerebral vessels as opposed to thrombosis used to be clarified and the relative frequency of thrombosis as opposed to embolism was once greater understood. the concept that of collateral stream of the mind via so-called meningeal end-to finish arterial anastomoses was once drastically larger understood while serial angiography in obstructive cerebral vascular disorder used to be performed with expanding frequency.
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Extra info for Angiography and Computed Tomography in Cerebro-Arterial Occlusive Diseases
In the late phases (b and c) a retrograde filling of the left internal carotid artery (_) by the way of the vertebrobasilar system is visible (see also Fig. 14d-f). Through the collateral circulation the patency of the left internal enotid artery is demonstrated d e Fig. 14d-f. Left vertebral angiogram in the same case as in Fig. 14a-c. ). f e and f Late phases: collateral circulation from the vertebrobasilar system by way of the posterior communicans (~) artery to the carotid siphon and further to the internal (~) carotid artery down to the bifurcation In ICA, the retrograde flow (through vertebral artery) and anterograde flow (through external carotid artery) join together.
C Right vertebral angiogram : vertebral artery (VR) is small and enters into the posterior inferior cerebellar artery (~); hypoplastic segment of the vertebral artery (_) to the basilar artery. d Left vertebral angiogram: vertebral artery (VL); retrograde filling of the right vertebral artery (_); left posterior inferior cerebellar artery (~); superior cerebellar arteries (_); posterior cerebral arteries (_); communicans posterior artery (~) 31 a b Fig. 4a-d. Examples of plaques and stenosis of the in- ternal carotid artery due to atherosclerosis.
4). Finally, other authors (THOMPSON and TALKINGTON 1976) have expressed the opinion that moderate stenosis may also be significant because a 50% reduction of the diameter corresponds to a 75% narrowing of the lumen area. The importance of correct angiographic technique in the diagnosis of ulcerative plaque of the internal carotid artery has been emphasized by MADDISON and MOORE (1969), WOOD and CORRELL (1969), Du BOULAY (1973), and WIGGLI and OBERSON (1973). The latter authors reported ulcerative lesions in 70% and suspected them in a further 10% of their patients examined after TIA.