By Horia Muresian
This publication covers all features of the prevention, prognosis, and remedy of stroke, delivering an built-in point of view that might be proper to more than a few experts. broad attention is given to different tools of stroke prevention and arterial revascularization, with up to date info on pharmacological measures and transparent presentation of endovascular stent placement tactics and surgical thoughts, together with these regarding the carotid artery, vertebral artery, and aortic arch. advanced approaches, reminiscent of simultaneous bilateral carotid revascularization, are mentioned extensive, drawing on a wide sequence of instances and starting up functional principles. The prognosis and therapy of intra- and extracranial aneurysms and the administration of cervical trauma are tested totally. moreover, the reader is supplied with assistance on characterization of the perpetrator lesion by way of diverse imaging modalities and with recommendation at the value of a multidisciplinary group and mixed techniques (endovascular and surgical), identity of possibility components, anesthesia, neuromonitoring, and hemodynamic tracking. The booklet should be of price not just for cardiac and vascular surgeons but in addition for cardiologists, neurologists, neurosurgeons, anesthesiologists, anatomists, experts in diagnostic imaging, and interventional radiologists.
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Extra resources for Arterial Revascularization of the Head and Neck: Text Atlas for Prevention and Management of Stroke
Itoyama Y, Kitano I, Ushio Y. Carotid and vertebral rete mirabile in man. Case report. Neurol Med Chir (Tokyo). 1993;33:181–4. 32. Yagi K, Satoh K, Satomi J, Nagahiro S. Primitive vertebrobasilar system associated with a ruptured aneurysm. AJNR Am J Neuroradiol. 2004;25(5):781–3. 33. Woodcock RJ, Cloft HJ, Dion JE. Bilateral type 1 proatlantal arteries with absence of vertebral arteries. AJNR Am J Neuroradiol. 2001;22(2):418–20. 34. Fischer E. Die Lageabweichungen der vorderen Hirnarterie im Gafässbild.
Current methods of evaluation are evolving. Indeed, anastomoses can be visualized angiographically. The lack of angiographical visualization of a collateral vessel does not actually reflect its absence, as opacification is flow dependent (and flow is also determined by the metabolic status of target brain tissue, which, at its turn, eventually rests on the type of ischemic lesion). Angiographic grading systems for regional collateral flow can predict the location and extent of infarction  and may be implemented in larger clinical trials.
The anastomoses presented so far are generally called secondary anastomoses in order to be differentiated from the most significant primary or main anastomoses located intracranially, at the base of the brain and forming the arterial circle of Willis (CoW). The CoW appears almost as ring like, although it is essentially a heptagon with the sides formed by the two posterior cerebral arteries (PCA), the two posterior communicating arteries (PCommA), the two anterior cerebral arteries (ACA), and the unpaired anterior communicating artery (ACommA).
Arterial Revascularization of the Head and Neck: Text Atlas for Prevention and Management of Stroke by Horia Muresian