[Cerebral sequelae of stenosing and occlusive diseases of the internal carotid artery. Importance of Doppler transcranial examination. Part 2].
The author reports 57 stenosis or occlusions of the internal carotid artery, 13 dissections and 44 atheromatous lesions. She studies the correlation between intracranial collateralisation detected by transcranial Doppler sonography (TCD) and clinical symptoms as well as lesions seen on cerebral CT-scan. Two types of ischaemic lesions are described: border-zone infarcts, probably haemodynamic in origin and territorial infarcts, probably thromboembolic. TCD lets suppose that strokes in this series have a thromboembolic origin. On the other hand it is possible that collateralisation depending on both anterior and posterior communicating arteries is not sufficient, because such a collateralisation is found above all in the 2 most severe symptomatic groups and in many territorial infarcts. In the atheromatous group, occlusions are often asymptomatic and territorial infarcts less extended, whereas in the dissections group all occlusions determined a territorial infarct, often very important. TCD alone doesn't allow to definitely conclude about pathogeny of ischaemic lesions nor on collateralisation value. The adjunction of CO2 reactivity tests in middle cerebral artery will perhaps give the clues of these problems.
Rohr-Le Floch
J
J
Clinique de Neurologie, Hôpital Cantonal Universitaire, Genève.
D001783:Blood Flow Velocity / Q000502:physiology; D002545:Brain Ischemia / Q000000981:diagnostic imaging*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging*; D003097:Collateral Circulation / Q000502:physiology; D004453:Echoencephalography; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging; D008297:Male; D014057:Tomography, X-Ray Computed
Conséquences cérébrales des maladies sténosantes et occlusives de l'artère carotide interne. Intérêt de l'examen Doppler transcrânien. Deuxième partie.