Abstract

MUSSENDEN, Osvaldo Eliseo. Clinical diagnosis of the extracranial cerebrovascular disease. Rev Cubana Angiol Cir Vasc. [online]. 2014, vol.15, n.2, pp. 109-120. ISSN 1682-0037.

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.

Keywords : extracranial cerebrovascular disease; cerebrovascular disease; focal cerebral ischemia; peripheral arterial disease; carotid endarterectomy; focal and non-focal ictus.

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