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Visualization of the Extracranial Cerebral Circulation by Cardio-Angiography

Robert Schramel, M.D.; Oscar Creech Jr., M.D.; Raeburn Llewellyn, M.D.; Richard Corales, M.D.
JAMA. 1961;175(9):804-805. doi:10.1001/jama.1961.63040090012019.
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THE DEVELOPMENT of surgical procedures to remove obstructions from major arteries supplying the brain has led to a reappraisal of traditional concepts regarding cerebral vascular disease. Thus, in a significant proportion of patients, symptoms of cerebral ischemia are due to atherosclerosis of arteries proximal to the brain. In the beginning it was hoped that the isolated, segmental lesion of carotid or vertebral arteries would be the major etiologic factor in strokes; however, subsequent experience has indicated that the problem is more complex than this. For instance, roentgenographic studies suggest that segmental lesions often involve more than one artery, that obstruction of extracranial and intracranial vessels may be present simultaneously, and that anomalies of the vertebral arteries are common. It has become evident, therefore, that complete arteriographic study of the cerebral circulation is essential if the distribution, frequency, and significance of obstructive lesions are to be known. Furthermore, the evaluation


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