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January 1988, Vol 106, No. 1 >
ARTICLE | January 1988

Carotid Artery Disease: Title and subTitle BreakA Therapeutic Enigma FREE

William L. Becker, MD; Ronald M. Burde, MD
Arch Ophthalmol. 1988;106(1):34-39. doi:10.1001/archopht.1988.01060130040024
Text Size: A A A
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Article
References
Comments

Many patients with carotid artery disease experience a diversity of ocular symptoms (Table). Thus, the ophthalmologist (1) is often the first physician to see the patient or (2) is asked to act as a consultant to identify structural disease, to confirm or to exclude the presence of retinal emboli, or to perform noninvasive tests reflecting the patency of the carotid circulation. During the past decade, a number of techniques for the diagnosis of carotid artery disease have been developed. There has been a concomitant increase in the number of endarterectomies performed (15000 in 1971 to 103 000 in 1984)2 on both symptomatic and asymptomatic patients. This rise has occurred despite little evidence to support the efficacy of the procedure.3-5 The majority of endarterectomies fall into the category of prophylactic surgery, in which the patient can be either asymptomatic (ie, patients with neck bruits revealed at routine physical examination)

REFERENCES

1 +
Kearns TP:  Differential diagnosis of central retinal vein obstruction . Ophthalmology 1983;;90:475-480.
2 +
Dyken ML, Pokras R:  The performance of endarterectomy for disease of the extracranial arteries of the head . Stroke 1984;;15:948-950.
3 +
Brott TC, Labutta RJ, Kempczinski RF:  Changing patterns in the practice of carotid endarterectomy in a large metropolitan area . JAMA 1986;;255:2609-2612.
4 +
Kistler JP, Ropper AH, Heros RC:  Therapy of ischemic cerebral vascular disease due to atherothrombosis (first of two parts) . N Engl J Med 1984;;311:27-34.
5 +
Barnett HJM, Plum F, Walton JN:  Carotid endarterectomy: An expression of concern . Stroke 1984;;15:941-943.
6 +
Sandok BA:  Noninvasive techniques for diagnosis of carotid artery disease . Stroke 1978;;9:427-429.
7 +
Hennerici M, Freund HJ:  Efficacy of CW-Doppler and duplex system examinations for the evaluation of extracranial carotid disease . J Clin Ultrasound 1984;;12:155-161.
8 +
Sanborn GE, Miller NR, Langham ME, et al:  An evaluation of currently available, noninvasive tests of carotid artery disease . Ophthalmology 1980;;87:435-439.
9 +
Mullie MA, Kirkham TH:  Ophthalmodynamometry revisited . Can J Ophthalmol 1983;;18:165-168.
10 +
Blackshear WM Jr, Thiele BL, Harley JD, et al:  A prospective evaluation of oculoplethysmography and carotid phonoangiography . Surg Gynecol Obstet 1979;;148:201-205.
11 +
Gutiérrez IZ, Makula PA, Gage AA:  The asymptomatic carotid bruit . Am Surg 1985;;51:388-391.
12 +
Bishop CC, Powell S, Insall M, et al:  Effect of internal carotid artery occlusion on middle cerebral artery blood flow at rest in the response to hypercapnia . Lancet 1986;;1:710-712.
13 +
Hennerici M, Rautenberg W, Trockel U, et al:  Spontaneous progression and regression of small carotid atheroma . Lancet 1985;;1:1415-1419.
14 +
Walsh J, Markowitz I, Kerstein MD:  Carotid endarterectomy for amaurosis fugax without angiography . Am J Surg 1986;;152:172-174.
15 +
Lo LY, Ford CS, McKinney WM, et al:  Asymptomatic bruit, carotid and vertebrobasilar transient ischemic attacks: A clinical and ultrasonic correlation . Stroke 1986;;17:65-68.
16 +
Kistler JP, Lees RS, Friedman J, et al:  The bruit of carotid stenosis vs radiated basal heart murmurs: Differentiation by phonoangiography . Circulation 1978;;57:975-981.
17 +
Vitek JJ:  Femoro-cerebral angiography: Analysis of 2000 consecutive examinations and special emphasis on carotid arteries catheterization in older patients . AJR 1973;;118:633-647.
18 +
Eikelboom BC, Riles TR, Mintzer R, et al:  Inaccuracy of angiography in the diagnosis of carotid ulceration . Stroke 1983;;14:882-885.
19 +
Powers WJ, Press GA, Grubb RL, et al:  The effect of hemodynamically significant carotid artery disease on the hemodynamic status of the cerebral circulation . Ann Intern Med 1987;;106:27-35.
20 +
Zbornikova V, Lassvik C:  Duplex scanning in persons of different ages who are presumed to be normal , abstracted. Acta Neurol Scand 1986;;73:529.
21 +
Chambers BR, Norris JW:  The case against surgery for asymptomatic carotid stenosis . Stroke 1984;;15:964-967.
22 +
Heyman A, Wilkinson WE, Hurwitz BJ, et al:  Risk of ischemic heart disease in patients with TIA . Neurology 1984;;34:626-630.
23 +
Ford CS, Frye JL, Toole JF, et al:  Asymptomatic carotid bruit and stenosis: A prospective follow-up study . Arch Neurol 1986;;43:219-222.
24 +
Hertzer NR, Flanagan RA Jr, O'Hara PJ, et al:  Surgical vs nonoperative treatment of asymptomatic carotid stenosis: 290 patients documented by intravenous angiography . Ann Surg 1986;;204:163-171.
25 +
Chambers BR, Norris JW:  Outcome in patients with asymptomatic neck bruits . N Engl J Med 1986;;315:860-865.
26 +
Roederer GO, Langlois YE, Jager KA, et al:  The natural history of carotid arterial disease in asymptomatic patients with cervical bruits . Stroke 1984;;15:605-613.
27 +
Bogousslavsky J, Despland PA, Regli F:  Asymptomatic tight stenosis of the internal carotid artery: Long-term prognosis . Neurology 1986;;36:861-863.
28 +
The Canadian Cooperative Study Group:  A randomized trial of aspirin and sulfinpyrazone in threatened stroke . N Engl J Med 1978;;299:53-59.
29 +
Fields WS, Lemak NA, Frankowski RF, et al:  Controlled trial of aspirin in cerebral ischemia: Part II. Surgical group . Stroke 1978;;9:309-319.
30 +
Weksler B, Pett S, Alonso D, et al:  Differential inhibition by aspirin of vascular and platelet prostaglandin synthesis in the atherosclerotic patient . N Engl J Med 1983;;308:800-805.
31 +
Hirsh J:  Progress review: The relationship between dose of aspirin, side-effects and antithrombotic effectiveness . Stroke 1985;;16:1-4.
32 +
Bousser MG, Eschwege E, Haguenau M, et al:  Essai coopératif contrôle 'AICLA': Prévention secondaire des accidents ischémiques cérébraux liés à l'athérosclérose par l'aspirine et le dipyridamole: 3e partie. Résultats . Rev Neurol 1983;;139:335-348.
33 +
 Amaurosis fugax, editorial . Lancet 1982;;1:838-839.
34 +
Sacks JG, Choromokos E:  Ophthalmodynamometry reveals retinal embolus . Ann Ophthalmol 1983;;15:413-414.
35 +
Safran AB:  Appearance of cholesterol embolism in the retina . J Clin Neuro Ophthalmol 1983;;3:191-192.
36 +
Muci-Mendoza R, Arruga J, Edward WO, et al:  Retinal fluorescein angiographic evidence for atheromatous microembolism: Demonstration of ophthalmoscopically occult emboli and postembolic endothelial damage after attacks of amaurosis fugax . Stroke 1980;;11:154-158.
37 +
Aasen JS, Russell D, Bakke SJ, et al:  Amaurosis fugax: Angiographic and Doppler findings . Acta Neurol Scand 1984;;69( (suppl 98) ):317-318.
38 +
Wilson LA, Russell RWR:  Amaurosis fugax and carotid artery disease: Indications for angiography . Br Med J 1977;:2:435-437.
39 +
Adams HP Jr, Putman SF, Corbett JJ, et al:  Amaurosis fugax: The results of arteriography in 59 patients . Stroke 1983;;14:742-744.
40 +
Sørensen PN:  Amaurosis fugax: An unselected material . Acta Ophthalmol 1983;;61:583-588.
41 +
Eadie MJ, Sutherland JM, Tyrer JH:  Recurrent monocular blindness of uncertain cause . Lancet 1968;;1:319-321.
42 +
Marshall J, Meadows S:  The natural history of amaurosis fugax . Brain 1968;;91:419-434.
43 +
Hurwitz BJ, Heyman A, Wilkinson WE, et al:  Comparison of amaurosis fugax and transient cerebral ischemia: A prospective clinical and arteriographic study . Ann Neurol 1985;;18:698-704.
44 +
Furlan AJ, Whisnant JP, Kearns TP:  Unilateral visual loss in bright light: An unusual symptom of carotid artery occlusive disease . Arch Neurol 1979;;36:675-676.
45 +
Kearns TP, Hollenhorst RW:  Venous-stasis retinopathy of occlusive disease of the carotid artery . Mayo Clin Proc 1963;;38:304-312.
46 +
Hollenhorst RW, Kublin JG, Millikan CH:  Ophthalmodynamometry in the diagnosis of intracerebral orthostatic hypotension . Mayo Clin Proc 1963;;38:532-547.
47 +
Sandok BA, Trautmann JC, Ramirez-Lassepas M, et al:  Clinical-angiographic correlations in amaurosis fugax . Am J Ophthalmol 1974;;79:137-142.
48 +
Genton E, Barnett HJM, Fields WS, et al:  Report of the Joint Committee for Stroke Resources: XIV. Cerebral ischemia: The role of thrombosis and of antithrombotic therapy . Stroke 1977;;8:150-175.
49 +
Heyman A, Leviton A, Millikan CH, et al:  Report of the Joint Committee for Stroke Resources: XI. Transient focal cerebral ischemia: Epidemiological and clinical aspects . Stroke 1974;;5:277-284.
50 +
Easton JD, Hart RG, Sherman DG, et al:  Diagnosis and management of ischemic stroke: Part 1. Threatened stroke and its management . Curr Probl Cardiol 1983;;8:1-76.
51 +
Veterans Administration Cooperative Study Group on Antihypertensive Agents:  Effects of treatment on morbidity in hypertension: I. Results in patients with diastolic blood pressure averaging 115 through 129 mm Hg . JAMA 1967;;202:1028-1034.
52 +
Veterans Administration Cooperative Study Group on Antihypertensive Agents:  Effects of treatment on morbidity in hypertension. II. Results in patients with diastolic blood pressures averaging 90 through 114 mm Hg . JAMA 1970;;213:1143-1152.
53 +
Bogousslavsky J, Hachinski VC, Boughner DR, et al:  Cardiac and arterial lesions in carotid transient ischemic attacks . Arch Neurol 1986;;43:223-228.
54 +
Bogousslavsky J, Hachinski VC, Boughner DR, et al:  Clinical preditors of cardiac and arterial lesions in carotid transient ischemic attacks . Arch Neurol 1986;;43:229-233.
55 +
Hertzer NR, Flanagan RA Jr, O'Hara PJ, et al:  Surgical vs nonoperative treatment of symptomatic carotid stenosis: 211 patients documented by intravenous angiography . Ann Surg 1986;;204:154-162.
56 +
Kistler JP, Ropper AH, Heros RC:  Therapy of ischemic cerebral vascular disease due to atherothrombosis (second of two parts) . N Engl J Med 1984;;311:100-105.
57 +
Baker RN:  An evaluation of anticoagulant therapy in the treatment of cerebrovascular disease: Report of the Veterans Administration Cooperative Study of Atherosclerosis . Neurology 1961;:11:132-138.
58 +
Baker RN, Broward JA, Fang HC, et al:  Anticoagulant therapy in cerebral infarction: Report on cooperative study . Neurology 1962;;12:823-835.
59 +
Baker RN, Schwartz WS, Rose AS:  Transient ischemic strokes: A report of a study of anticoagulant therapy . Neurology 1966;;16:841-847.
60 +
Millikan CH, McDowell FH:  Treatment of transient ischemic attacks . Stroke 1978;;9:299-308.
61 +
Olsson JE, Brechter C, Bäcklund H, et al:  Anticoagulant vs antiplatelet therapy as prophylactic against cerebral infarction in transient ischemic attacks . Stroke 1980;;14:5-14.
62 +
Levine M, Hirsh J:  Hemorrhagic complications of long-term anticoagulant therapy for ischemic cerebral vascular disease . Stroke 1986;;17:111-116.
63 +
Jonas S, Hass WK:  An approach to the maximal acceptance stroke complication rate after surgery for transient cerebral ischemia (TIA) . Stroke 1979;;10:104.
64 +
Hass WK:  Caution falling rock zone: An analysis of the medical and surgical management of threatened stroke . Proc Inst Med Chicago 1980;;33:80-84.
65 +
Grotta JC, Bigelow RH, Hu H, et al:  The significance of carotid stenosis or ulceration . Neurology 1984;;34:437-442.
66 +
Harrison MJG, Marshall J:  Prognostic significance of severity of carotid atheroma in early manifestations of cerebrovascular disease . Stroke 1982;;13:567-569.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Kearns TP:  Differential diagnosis of central retinal vein obstruction . Ophthalmology 1983;;90:475-480.
2 +
Dyken ML, Pokras R:  The performance of endarterectomy for disease of the extracranial arteries of the head . Stroke 1984;;15:948-950.
3 +
Brott TC, Labutta RJ, Kempczinski RF:  Changing patterns in the practice of carotid endarterectomy in a large metropolitan area . JAMA 1986;;255:2609-2612.
4 +
Kistler JP, Ropper AH, Heros RC:  Therapy of ischemic cerebral vascular disease due to atherothrombosis (first of two parts) . N Engl J Med 1984;;311:27-34.
5 +
Barnett HJM, Plum F, Walton JN:  Carotid endarterectomy: An expression of concern . Stroke 1984;;15:941-943.
6 +
Sandok BA:  Noninvasive techniques for diagnosis of carotid artery disease . Stroke 1978;;9:427-429.
7 +
Hennerici M, Freund HJ:  Efficacy of CW-Doppler and duplex system examinations for the evaluation of extracranial carotid disease . J Clin Ultrasound 1984;;12:155-161.
8 +
Sanborn GE, Miller NR, Langham ME, et al:  An evaluation of currently available, noninvasive tests of carotid artery disease . Ophthalmology 1980;;87:435-439.
9 +
Mullie MA, Kirkham TH:  Ophthalmodynamometry revisited . Can J Ophthalmol 1983;;18:165-168.
10 +
Blackshear WM Jr, Thiele BL, Harley JD, et al:  A prospective evaluation of oculoplethysmography and carotid phonoangiography . Surg Gynecol Obstet 1979;;148:201-205.
11 +
Gutiérrez IZ, Makula PA, Gage AA:  The asymptomatic carotid bruit . Am Surg 1985;;51:388-391.
12 +
Bishop CC, Powell S, Insall M, et al:  Effect of internal carotid artery occlusion on middle cerebral artery blood flow at rest in the response to hypercapnia . Lancet 1986;;1:710-712.
13 +
Hennerici M, Rautenberg W, Trockel U, et al:  Spontaneous progression and regression of small carotid atheroma . Lancet 1985;;1:1415-1419.
14 +
Walsh J, Markowitz I, Kerstein MD:  Carotid endarterectomy for amaurosis fugax without angiography . Am J Surg 1986;;152:172-174.
15 +
Lo LY, Ford CS, McKinney WM, et al:  Asymptomatic bruit, carotid and vertebrobasilar transient ischemic attacks: A clinical and ultrasonic correlation . Stroke 1986;;17:65-68.
16 +
Kistler JP, Lees RS, Friedman J, et al:  The bruit of carotid stenosis vs radiated basal heart murmurs: Differentiation by phonoangiography . Circulation 1978;;57:975-981.
17 +
Vitek JJ:  Femoro-cerebral angiography: Analysis of 2000 consecutive examinations and special emphasis on carotid arteries catheterization in older patients . AJR 1973;;118:633-647.
18 +
Eikelboom BC, Riles TR, Mintzer R, et al:  Inaccuracy of angiography in the diagnosis of carotid ulceration . Stroke 1983;;14:882-885.
19 +
Powers WJ, Press GA, Grubb RL, et al:  The effect of hemodynamically significant carotid artery disease on the hemodynamic status of the cerebral circulation . Ann Intern Med 1987;;106:27-35.
20 +
Zbornikova V, Lassvik C:  Duplex scanning in persons of different ages who are presumed to be normal , abstracted. Acta Neurol Scand 1986;;73:529.
21 +
Chambers BR, Norris JW:  The case against surgery for asymptomatic carotid stenosis . Stroke 1984;;15:964-967.
22 +
Heyman A, Wilkinson WE, Hurwitz BJ, et al:  Risk of ischemic heart disease in patients with TIA . Neurology 1984;;34:626-630.
23 +
Ford CS, Frye JL, Toole JF, et al:  Asymptomatic carotid bruit and stenosis: A prospective follow-up study . Arch Neurol 1986;;43:219-222.
24 +
Hertzer NR, Flanagan RA Jr, O'Hara PJ, et al:  Surgical vs nonoperative treatment of asymptomatic carotid stenosis: 290 patients documented by intravenous angiography . Ann Surg 1986;;204:163-171.
25 +
Chambers BR, Norris JW:  Outcome in patients with asymptomatic neck bruits . N Engl J Med 1986;;315:860-865.
26 +
Roederer GO, Langlois YE, Jager KA, et al:  The natural history of carotid arterial disease in asymptomatic patients with cervical bruits . Stroke 1984;;15:605-613.
27 +
Bogousslavsky J, Despland PA, Regli F:  Asymptomatic tight stenosis of the internal carotid artery: Long-term prognosis . Neurology 1986;;36:861-863.
28 +
The Canadian Cooperative Study Group:  A randomized trial of aspirin and sulfinpyrazone in threatened stroke . N Engl J Med 1978;;299:53-59.
29 +
Fields WS, Lemak NA, Frankowski RF, et al:  Controlled trial of aspirin in cerebral ischemia: Part II. Surgical group . Stroke 1978;;9:309-319.
30 +
Weksler B, Pett S, Alonso D, et al:  Differential inhibition by aspirin of vascular and platelet prostaglandin synthesis in the atherosclerotic patient . N Engl J Med 1983;;308:800-805.
31 +
Hirsh J:  Progress review: The relationship between dose of aspirin, side-effects and antithrombotic effectiveness . Stroke 1985;;16:1-4.
32 +
Bousser MG, Eschwege E, Haguenau M, et al:  Essai coopératif contrôle 'AICLA': Prévention secondaire des accidents ischémiques cérébraux liés à l'athérosclérose par l'aspirine et le dipyridamole: 3e partie. Résultats . Rev Neurol 1983;;139:335-348.
33 +
 Amaurosis fugax, editorial . Lancet 1982;;1:838-839.
34 +
Sacks JG, Choromokos E:  Ophthalmodynamometry reveals retinal embolus . Ann Ophthalmol 1983;;15:413-414.
35 +
Safran AB:  Appearance of cholesterol embolism in the retina . J Clin Neuro Ophthalmol 1983;;3:191-192.
36 +
Muci-Mendoza R, Arruga J, Edward WO, et al:  Retinal fluorescein angiographic evidence for atheromatous microembolism: Demonstration of ophthalmoscopically occult emboli and postembolic endothelial damage after attacks of amaurosis fugax . Stroke 1980;;11:154-158.
37 +
Aasen JS, Russell D, Bakke SJ, et al:  Amaurosis fugax: Angiographic and Doppler findings . Acta Neurol Scand 1984;;69( (suppl 98) ):317-318.
38 +
Wilson LA, Russell RWR:  Amaurosis fugax and carotid artery disease: Indications for angiography . Br Med J 1977;:2:435-437.
39 +
Adams HP Jr, Putman SF, Corbett JJ, et al:  Amaurosis fugax: The results of arteriography in 59 patients . Stroke 1983;;14:742-744.
40 +
Sørensen PN:  Amaurosis fugax: An unselected material . Acta Ophthalmol 1983;;61:583-588.
41 +
Eadie MJ, Sutherland JM, Tyrer JH:  Recurrent monocular blindness of uncertain cause . Lancet 1968;;1:319-321.
42 +
Marshall J, Meadows S:  The natural history of amaurosis fugax . Brain 1968;;91:419-434.
43 +
Hurwitz BJ, Heyman A, Wilkinson WE, et al:  Comparison of amaurosis fugax and transient cerebral ischemia: A prospective clinical and arteriographic study . Ann Neurol 1985;;18:698-704.
44 +
Furlan AJ, Whisnant JP, Kearns TP:  Unilateral visual loss in bright light: An unusual symptom of carotid artery occlusive disease . Arch Neurol 1979;;36:675-676.
45 +
Kearns TP, Hollenhorst RW:  Venous-stasis retinopathy of occlusive disease of the carotid artery . Mayo Clin Proc 1963;;38:304-312.
46 +
Hollenhorst RW, Kublin JG, Millikan CH:  Ophthalmodynamometry in the diagnosis of intracerebral orthostatic hypotension . Mayo Clin Proc 1963;;38:532-547.
47 +
Sandok BA, Trautmann JC, Ramirez-Lassepas M, et al:  Clinical-angiographic correlations in amaurosis fugax . Am J Ophthalmol 1974;;79:137-142.
48 +
Genton E, Barnett HJM, Fields WS, et al:  Report of the Joint Committee for Stroke Resources: XIV. Cerebral ischemia: The role of thrombosis and of antithrombotic therapy . Stroke 1977;;8:150-175.
49 +
Heyman A, Leviton A, Millikan CH, et al:  Report of the Joint Committee for Stroke Resources: XI. Transient focal cerebral ischemia: Epidemiological and clinical aspects . Stroke 1974;;5:277-284.
50 +
Easton JD, Hart RG, Sherman DG, et al:  Diagnosis and management of ischemic stroke: Part 1. Threatened stroke and its management . Curr Probl Cardiol 1983;;8:1-76.
51 +
Veterans Administration Cooperative Study Group on Antihypertensive Agents:  Effects of treatment on morbidity in hypertension: I. Results in patients with diastolic blood pressure averaging 115 through 129 mm Hg . JAMA 1967;;202:1028-1034.
52 +
Veterans Administration Cooperative Study Group on Antihypertensive Agents:  Effects of treatment on morbidity in hypertension. II. Results in patients with diastolic blood pressures averaging 90 through 114 mm Hg . JAMA 1970;;213:1143-1152.
53 +
Bogousslavsky J, Hachinski VC, Boughner DR, et al:  Cardiac and arterial lesions in carotid transient ischemic attacks . Arch Neurol 1986;;43:223-228.
54 +
Bogousslavsky J, Hachinski VC, Boughner DR, et al:  Clinical preditors of cardiac and arterial lesions in carotid transient ischemic attacks . Arch Neurol 1986;;43:229-233.
55 +
Hertzer NR, Flanagan RA Jr, O'Hara PJ, et al:  Surgical vs nonoperative treatment of symptomatic carotid stenosis: 211 patients documented by intravenous angiography . Ann Surg 1986;;204:154-162.
56 +
Kistler JP, Ropper AH, Heros RC:  Therapy of ischemic cerebral vascular disease due to atherothrombosis (second of two parts) . N Engl J Med 1984;;311:100-105.
57 +
Baker RN:  An evaluation of anticoagulant therapy in the treatment of cerebrovascular disease: Report of the Veterans Administration Cooperative Study of Atherosclerosis . Neurology 1961;:11:132-138.
58 +
Baker RN, Broward JA, Fang HC, et al:  Anticoagulant therapy in cerebral infarction: Report on cooperative study . Neurology 1962;;12:823-835.
59 +
Baker RN, Schwartz WS, Rose AS:  Transient ischemic strokes: A report of a study of anticoagulant therapy . Neurology 1966;;16:841-847.
60 +
Millikan CH, McDowell FH:  Treatment of transient ischemic attacks . Stroke 1978;;9:299-308.
61 +
Olsson JE, Brechter C, Bäcklund H, et al:  Anticoagulant vs antiplatelet therapy as prophylactic against cerebral infarction in transient ischemic attacks . Stroke 1980;;14:5-14.
62 +
Levine M, Hirsh J:  Hemorrhagic complications of long-term anticoagulant therapy for ischemic cerebral vascular disease . Stroke 1986;;17:111-116.
63 +
Jonas S, Hass WK:  An approach to the maximal acceptance stroke complication rate after surgery for transient cerebral ischemia (TIA) . Stroke 1979;;10:104.
64 +
Hass WK:  Caution falling rock zone: An analysis of the medical and surgical management of threatened stroke . Proc Inst Med Chicago 1980;;33:80-84.
65 +
Grotta JC, Bigelow RH, Hu H, et al:  The significance of carotid stenosis or ulceration . Neurology 1984;;34:437-442.
66 +
Harrison MJG, Marshall J:  Prognostic significance of severity of carotid atheroma in early manifestations of cerebrovascular disease . Stroke 1982;;13:567-569.

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