The management of patients with internal carotid artery stenosis needs to focus on the occurrence and identification of neurological symptoms, the degree and morphology of the stenosis and the determination of the mechanism of cerebral ischemia. Thus neuroimaging studies are an integral part of the neurologist's assessment of these patient and individual therapeutic decisions. Since a differentiated approach is not always taken and patients by far too often undergo surgical or interventional treatment without a proper neurological evaluation, the material presented in this review demonstrates the possibilities of such a critical assessment concerning brain and vascular imaging findings and new techniques as well as modern concepts of plaque vulnerability improving the understanding of the pathophysiology and mechanisms of ischemic symptoms in internal carotid artery disease. Furthermore, the results of recent clinical trails that need to be integrated in the optimal treatment plan of these patients are discussed.
Symptomatic carotid artery stenosis: a solvable problem. North American Symptomatic carotid Endarterectomy Trial
MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis. European Carotid Surgery Trialists' Collaborative Group
Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis
Natural history of asymptomatic extracranial arterial disease. Results of a long-term prospective study
Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study
Pitfalls in MR measurement of tissue blood flow with intravascular tracers: which mean transit time?
Assessment of regional cerebral blood volume in acute human stroke by use of single-slice dynamic susceptibility contrast-enhanced magnetic resonance imaging
Cerebrovascular reserve capacity in patients with occlusive cerebrovascular disease: assessment with dynamic susceptibility contrast-enhanced MR imaging and the acetazolamide stimulation test
High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part I: Mathematical approach and statistical analysis
Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators
Impaired clearance of emboli (washout) is an important link between hypoperfusion, embolism, and ischemic stroke
Prediction of benefit from carotid endarterectomy in individual patients: a risk-modelling study. European Carotid Surgery Trialists' Collaborative Group
Perfusion magnetic resonance imaging with continuous arterial spin labeling: methods and clinical applications in the central nervous system
Four-dimensional ultrasonographic characterization of plaque surface motion in patients with symptomatic and asymptomatic carotid artery stenosis
Diffusion- and perfusion-weighted MRI: influence of severe carotid artery stenosis on the DWI/PWI mismatch in acute stroke
Acute stroke patterns in patients with internal carotid artery disease: a diffusion-weighted magnetic resonance imaging study
Hemostasis and Thrombosis: Clinical Usefulness of Combined use of Platelet Aggregation Test and Anti PF4-H. Antibodies Elisa test for the Diagnosis of Heparin Induced Thrombocytopenia
Endovascular versus surgical treatment in patients with carotid stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomised trial
Lesion patterns and mechanism of ischemia in internal carotid artery disease: a diffusion-weighted imaging study
Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis
Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery
International carotid stenting study: protocol for a randomised clinical trial comparing carotid stenting with endarterectomy in symptomatic carotid artery stenosis
Internal carotid artery occlusion assessed at pulsed arterial spin-labeling perfusion MR imaging at multiple delay times
30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trial
Middle cerebral artery pulsatility index and cognitive improvement after carotid endarterectomy for symptomatic stenosis
Communication of inwardly projecting neovessels with the lumen contributes to symptomatic intraplaque hemorrhage in carotid artery stenosis
Prognostic value of preoperative border-zone (watershed) infarcts on the early postoperative outcomes of carotid endarterectomy after acute ischemic stroke
Influence of the type of cerebral infarct and timing of intervention in the early outcomes after carotid endarterectomy for symptomatic stenosis
Watershed infarcts in transient ischemic attack/minor stroke with > or = 50% carotid stenosis: hemodynamic or embolic?
Microembolism versus hemodynamic impairment in rosary-like deep watershed infarcts: a combined positron emission tomography and transcranial Doppler study
Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.
Carotid Artery Diseases
Carotid artery disease is a group of pathological conditions of the carotid artery. Discover the latest research on carotid artery disease here.