Because of increased interest in the evaluation of extracranial occlusive lesions causing the stroke syndrome, the study of both carotid and both vertebral vessels in the neck has been found desirable. This paper deals with our first 90 cases studied by 4-vessel angiography. These will be used for analysis of the angiographic anatomical findings in the vertebral-basilar system.
The material includes 28 patients in whom carotid artery disease was the primary clinical diagnosis. These patients had unilateral focal abnormalities of motion and sensation or both with or without dysphasia or aphasia. Many had recurrent focal neurological episodes with weakness or paralysis (including speech abnormalities) lasting for an hour or less. There were 35 patients in whom vertebral-basilar artery disease was suspected on the basis of a history of dizziness, diplopia, tinnitus, homonomous visual defects, and cranial nerve dysfunction. In 20 other cases, occlusive cerebrovascular disease was suspected as being