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70 percent stenosis of the right internal carotid artery as seen by ultrasound. Arrow marks the lumen of the artery. CT image of a 70 percent stenosis of the right internal carotid artery. Carotid artery stenosis is usually diagnosed by color flow duplex ultrasound scan of the carotid arteries in the neck.
Posterior cerebral artery syndrome is a condition whereby the blood supply from the posterior cerebral artery (PCA) is restricted, leading to a reduction of the function of the portions of the brain supplied by that vessel: the occipital lobe, the inferomedial temporal lobe, a large portion of the thalamus, and the upper brainstem and midbrain.
Middle cerebral artery syndrome is a condition whereby the blood supply from the middle cerebral artery (MCA) is restricted, leading to a reduction of the function of the portions of the brain supplied by that vessel: the lateral aspects of frontal, temporal and parietal lobes, the corona radiata, globus pallidus, caudate and putamen.
Where VBI is causing reproducible symptoms due to stenosis, lifestyle modification to avoid provoking factors (e.g. dehydration, standing rapidly from sitting or lying) may reduce symptoms. Open surgical repair or stenting can be performed to re-open stenosed vertebral arteries, and intracranial stents have also been successfully used. [9]
If the amaurosis fugax is caused by an atherosclerotic lesion, use of aspirin as an anticoagulant is indicated, and a carotid endarterectomy considered based on the location and grade of the stenosis. Generally, if the carotid artery is still patent, the greater the stenosis, the greater the indication for endarterectomy.
Stenosis (from Ancient Greek στενός (stenós) 'narrow') is the abnormal narrowing of a blood vessel or other tubular organ or structure such as foramina and canals. It is also sometimes called a stricture (as in urethral stricture ).
Management of cranial venous outflow obstruction involves treating the underlying cause, if identifiable, and managing the symptoms. This can include medication to reduce intracranial pressure, anticoagulation therapy to prevent thrombosis, and in some cases, surgical intervention to restore normal venous drainage. [6] [11]
The preferred treatment of Spetzler-Martin grade 1 and 2 AVMs in young, healthy patients is surgical resection due to the relatively small risk of neurological damage compared to the high lifetime risk of hemorrhage. Grade 3 AVMs may or may not be amenable to surgery. Grade 4 and 5 AVMs are not usually surgically treated. [23]
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