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DIAGNOSIS AND TREATMENT OF STROKES: CLINICAL ASPECTS
Author(s) -
BILLINGS JOHN
Publication year - 1963
Publication title -
australasian annals of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0571-9283
DOI - 10.1111/imj.1963.12.2.102
Subject(s) - medicine , cardiology , cerebral infarction , infarction , etiology , radiology , myocardial infarction , surgery , ischemia
SUMMARY A detailed investigation of patients admitted to St. Vincent's Hospital, Melbourne, with the diagnosis of “cerebrovascular accident” has been carried out. The radiological studies in particular have demonstrated that clinical diagnosis is very inadequate. A common mistake is the diagnosis of infarction in the presence of localized intracerebral hæmorrhage. The variable symptomatology of apparently identical vascular lesions can be understood only when the whole of the vascular tree from the aortic arch upwards is displayed by arteriography. In more than 20% of cases of cerebral infarction, no evidence of vascular obstruction could be obtained. A “flow‐failure” theory is postulated in some of these cases ; in the presence of generalized degenerative changes in the vessels of the neck and the brain, a transient fall of blood pressure, possibly due to weakened left ventricular contraction, may cause cerebral infarction.