[Atherosclerosis and cerebral ischemia. A systemic process].
BACKGROUND
Atherosclerosis is a systemic process involving all the arteries of the body. It is often silent, until its progression affects an organ causing a cerebral infarct, myocardial infarct or peripheral vascular disease.


METHODS
We consider three distinct aspects of this systemic involvement: the risk factors which are common to atherosclerosis at any site; previous alterations of other vascular regions apart from the current disorder, and the frequent presentation of a new site of vascular disorder, mainly coronary. The authors discuss the evolution of our understanding of cerebral ischaemia and the process of atherosclerosis. Atherosclerosis of the intracranial arteries leading to thrombosis was considered for many years to be the main cause of cerebral infarcts. However, this has been shown to be an unusual cause. The commonest cause has been found to be atheromatosis of the extracranial arteries leading to stenosis, ulceration or thrombosis. The aorta, the artery which is the first and most severely altered by the process of atherosclerosis, is often the cause of a cerebral infarct of unknown aetiology. The embolic etiology of cardiac origin is generally due to valvulopathies and disorders of rhythm and, less frequently, to myocardial ischaemia.


CONCLUSIONS
Atherosclerosis of arteries of the limbs is an indicator of systemic atherosclerosis but not a common etiological factor of cerebral infarct.
Unidad de Enfermedades Vasculares Cerebrales, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, España.
J L
JL
Martí-Vilalta
J
J
Martí-Fàbregas
D001161:Arteriosclerosis / Q000150:complications*; D001921:Brain / Q000098:blood supply*; D002545:Brain Ischemia / Q000209:etiology*; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D020767:Intracranial Thrombosis / Q000209:etiology; D012307:Risk Factors
Aterosclerosis e isquemia cerebral. Un proceso sistémico.