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April 13, 1970

The Neglected Cause of Stroke: Occlusion of the Smaller Intracranial Arteries and Their Diagnosis by Cerebral Angiography

Author Affiliations

Long Island Jewish Hospital New Hyde Park, NY

JAMA. 1970;212(2):326. doi:10.1001/jama.1970.03170150080035

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In the pathogenesis of stroke, occlusion of smaller intracranial arteries is recognized as one of the important elements in differential diagnosis. Dr. Ring, basing his conclusions on anatomic preparations and angiograms in conjunction with clinical features, makes a useful contribution in stressing this condition. He reviews other causes of stroke, such as extracranial and major vessel intracranial lesions, and places them in juxtaposition with lesser vessel occlusions. Following a brief discussion of the hemodynamics of the circulatory system of the brain is an anatomic analysis of the major intracerebral arteries. Dr. Ring's correlations between radiologic and postmortem anatomy are the result of intensive study. The detailed descriptions of the middle, the anterior cerebral, and pericallosal and the posterior cerebral arteries are particularly good. The anatomic data are utilized in bringing into focus the changes which might be anticipated from cerebral angiograms, particularly insofar as occlusions of secondary branches are concerned.