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November 1964

Extracranial Cerebrovascular Disease Treated Surgically: Study of 100 Patients

Author Affiliations

From the departments of peripheral vascular disease and vascular surgery, The Cleveland Clinic Foundation.

Arch Surg. 1964;89(5):848-855. doi:10.1001/archsurg.1964.01320050094008

Introduction  Cerebrovascular insufficiency is a common manifestation of arteriosclerosis. A resulting stroke not only is often permanently incapacitating but also is the third most common cause of death in the United States. In a substantial number of patients, the responsible lesions are in the extracranial arteries that supply the brain, and many of these lesions are surgically correctable.In spite of the seriousness of this problem, there is no general agreement as to the best approach to diagnosis, prophylaxis, or treatment. Several authors2,4,6,7,9 have reported that often there is little correlation between the clinical hisory, the physical findings, and the demonstrated disease. Controversy exists in regard to the values and dangers of various diagnostic procedures. Methods of treatment range from surgical repair in asymptomatic patients with bruits in the neck to the administration of "cerebral vasodilators" of doubtful long-term value.Lack of agreement is due chiefly to insufficient knowledge

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