Eliseo MO

Language: Spanish
References: 19
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ABSTRACT

Introduction: the most common etiology of the extracranial cerebrovascular disease is atherosclerosis of the carotid bifurcation. Its clinical diagnosis is fundamental to adopt the therapeutic measures needed to reduce, by means of ictus prevention, the devastating complications and the high costs derived from it.
Objective: to update on the main clinical manifestations of the extracranial cerebrovascular disease and to emphasize the usefulness of the clinical method for the right ischemic event.
Methods: the searched sources were PubMed, MedLine and the Strok.aha.journal.org.com (American Heart Association Web) where the longitudinal and descriptive cohort studies of last five years, and some texts on the subject included in the Handbook of Cerebrovascular Disease and the Neuro-interventional Technique were reviewed.
Information synthesis: this paper summarized the accumulated experiences collected in the literature about the different clinical manifestations, the demographic characteristics, the main surgical risk factors, and the association of the disease with vascular lesions occured in other locations (abdominal aorta and the lower extremity arteries), thus evidencing their association with the disease prognosis.
Conclusions: the extracranial cerebrovascular disease is an illness of multiple causes, whose clinical diagnosis offers the understanding of the neurological event as such and the classification indicates the medical behavior to be followed. It should be initially managed by clinical neurologists, internists and family physicians, but this disease must be treated with a multidisciplinary approach, being the vascular surgeon the one who plays the key role in the secondary prevention of the stroke.

REFERENCES

1. King U, Im JM, Tang TY, Patterson A. Characterisation of carotid atheroma in symptomatic and asymptomatic patients using high resolution MRI. J Neurol Neurosurg Psychiatry. 2008;79:905-12.

2. Flynn RW, MacWalter RS, Doney AS. The cost of cerebral ischaemia. Rev Neuropharmacol. 2008;55(3):250-6.

3. Mohr JP, Mast H. Carotid artery disease. In: Mohr JP, Wolf PA, Grotta JC, Moskowitz MA, Mayberg MR, von Kummer R, editors. Stroke: pathophysiology, diagnosis, and management. 5th ed. Philadelphia: Elsevier; 2011. p. 334-61.

4. Ratchford EV, Jin Z, Di Tullio MR. Carotid bruit for detection of hemodynamically significant carotid stenosis: the Northern Manhattan Study. Neurol Res. 2009;31:748- 52.

5. Meairs S, Hennerici M, Mohr JP. Ultrasonography. In: Mohr JP, Wolf PA, Grotta JC, Moskowitz MA, Mayberg MR, von Kummer R, editors. Stroke: pathophysiology, diagnosis, and management. 5th ed. Philadelphia: Elsevier; 2011. p. 831-69.

6. Warach S, Baird AE, Dani KA, Wintermark M, Kidwell CS. Magnetic resonance imaging of cerebrovascular diseases. In: Mohr JP, Wolf PA, Grotta JC, Moskowitz MA, Mayberg MR, von Kummer R, editors. Stroke: pathophysiology, diagnosis, and management. 5th ed. Philadelphia: Elsevier; 2011. p. 882-909.

7. Kummer R, editor. Stroke: pathophysiology, diagnosis, and management. 5th ed. Philadelphia: Elsevier; 2001.

8. Davis SM, Donnan GA. Secondary prevention after ischemic stroke or transient ischemic attack. N Engl J Med. 2012;366:1914-22.

9. Furie KL, Kasner SE, Adams RJ. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:227-76.

10. Grundy SM, Cleeman JI, Merz C. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. J Am Coll Cardiol. 2004;44(3):72032.

11. Adams HR; Special Writing Group of the Stroke Council, American Heart Association. Guidelines for the management of patients with acute ischemic stroke: a synopsis. Heart Dis Stroke. 1994;3(6):407-11.

12. Guidelines for management of ischaemic stroke and transient ischaemic attack. Cerebrovasc Dis. 2008;25:457-507.

13. Fernández O. Buergo MA. Diagnóstico de la enfermedad cerebrovascular isquémica. Resumed. 2000;13(4):159-69.

14. Brott TG, Halperin JL, Abbara S. Guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary. Catheter Cardiovasc Interv. 2013;81:E76-E123.

15. Bushnell Ch, McCullough LD, Awad IA, Chireau MV, Fedder WN. Guidelines for the prevention of stroke in women. American Heart Association Stroke Council. 2014;45(2):

16. Bonati LH, Dobson J, Algra A. Short-term outcome after stenting versus endarterectomy for symptomatic carotid stenosis: a preplanned meta-analysis of individual patient data. Lancet. 2010;376:1062-73.

17. Yaya HR. El paciente sintomático, signomático y asintomático: Metodología diagnósticas. En: Capdevila JM, editor. Temas a debate sobre cirugía vascular. Barcelona: URIACH; 1987.p. 12-4.

18. Harrigan MR, Deveikis J. Handbook of cerebrovascular disease and neurointerventional technique. Chapter 18. New York: Humans Press; 2009.

19. Billet J, Love B, Schneck M. Ischemia cerebrovascular disease. En: Daroff RB, editor. Bradley's neurology in clinical practice. Vascular disease of the nervous system. V II. Philadelphia: Elsevier; 2012. p. 1-51.