Cerebrovascular Insufficiency

"Carotid" derives from a Greek word meaning "stupefy"; compression of these arteries has long been known to induce sleepiness. Today, carotid endarterectomy is the most common peripheral vascular operation performed in America. Even so, the subject of cerebrovascular insufficiency continues to confound us. Perhaps most bewildering is whether to operate in the face of an acute neurological deficit. Timely surgery can reverse the evanescent uncoupling between blood flow and regional metabolism sometimes seen after a stroke. In selected patients with stroke-in-evolution, surgery is here proved safe and helpful. Vascular surgeons and neurologists are, thus, cautiously changing their minds about who else to operate on. Indeed the buzzword of this book is "change": change in our concepts of carotid atherogenesis, why ulcers form on lesions, the pendulation in presumed etiological importance between stenosis v embolization, and modifications in diagnostic and therapeutic maneuvers are all magnificently reviewed. While the book aims primarily