The angiographic evaluation of cerebral atherosclerosis.

The present report is based on a review of the angiographic studies obtained in a series of 200 consecutive cases admitted to the Cerebral Vascular Service of Detroit Memorial Hospital with the clinical diagnosis of “stroke” or “cerebral vascular accident.” Every such case was studied by carotid or vertebral angiography or both. In the earlier cases only the side implicated by clinical and neurological findings was examined, but later, as more knowledge of the processes involved was gained, all cases were studied by bilateral carotid angiography and as many as possible by vertebral angiography as well. In all cases angiograms were obtained by percutaneous injection (both for carotid and vertebral studies) of 8 to 10 c.c. of 50 per cent Hypaque, in most cases under local anesthesia only. From two to as many as eight injections were given, with but one untoward reaction, an immediate fatality in a sixty-year-old woman who was critically ill with both cerebral vascular symptoms and severe paroxysmal hyperten...