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Introduction

Diagnosis

Each region of the brain has a well-defined function. The symptoms felt by the patient depend on which region of the brain has been damaged (figure 1).

In order to know whether a carotid stenosis should be operated on and when it is appropriate to operate on it, it is necessary to perform additional examinations. Two examinations are very important:

A – Examination of the brain (figure 2)

This examination reveals whether a portion of the brain was destroyed, in which region and the extent of the destruction. In the event of an extensive cerebral infarction, the injection of a contrast medium into the patient during the examination makes it possible to assess the extent of brain healing. This is very important when deciding on a date for the surgical procedure.

B – Examination of the carotid artery

The purpose of this examination is to determine the extent of the stenosis (narrowing) of the carotid artery (figures 3 and 4), and to study the structure of the plaque in search of elements indicating the seriousness of the disease (necrosis, ulcer, blood clot).

It is relatively easy to determine the extent of the stenosis. But it is much more difficult to analyze the structure of the plaque, and errors are frequent. It is sometimes necessary to proceed with several different examinations of the bifurcation of the common carotid artery and to compare them before a decision can be made.

The most important element for deciding to operate on the carotid artery is the extent of the stenosis.

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