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Index 377
collateral pathways 139, 141,142
types 142
plaque 21 7
sample volume 10
stenosis 90, 90, 217
thrombosis 340
communicating arteries see anterior
communicating artery (ACoA);
posterior communicating artery
(PCoA)
computed tomographic angiography
(CTA) 116–119 , 118 ,119,349
BA occlusions 181, 267
cerebral venous thrombosis 331
contraindications 118
dissecting aneurysms 311
dissection 193
historical development 116
near occlusion 224
stenosis assessment 154–155
carotid 132
strengths and disadvantages
117–119
subclavian steal phenomenon 330
subtraction CTA 117
technical aspects 116–117, 117
thrombus 137
see also Charité University Hospital
algorithm
continuous-wave (CW) mode 7
contrast agents 8, 8, 24, 25
thrombolysis and 180
contrast-enhanced perfusion analysis
60
COSS (Carotid Occlusion Surgery
Study) 304
cross-flow 101, 101
D
dark halo sign 227, 229, 230
DEDAS (Dose Escalation Study of
Desmoteplase in Acute Ischemic
Stroke) 181
deep cervical vein 43
deep middle cerebral vein (DMCV) 41,
43–44
anatomy 43
identification 43–44, 44
diameter measurement of stenosis 82
DIAS (Desmoteplase In Acute Stroke)
study 181
diffuse cerebral angiomatosis case
history 312–318
digital subtraction angiography (DSA)
111–113 , 112 ,119,349
arteriovenous malformation 143
cerebral circulatory arrest 163
cerebral venous thrombosis 336
collateral pathways 237
contraindications 113
DSA delay test 260
fibromuscular dysplasia 208
his t o ri ca l de ve lo p me nt 111–112
moyamoya disease 174
near occlusion 223
occlusions 181
MCA, with early temporal branch
277
stenosis assessment 154
carotid siphon 214
ICA 128,132
MCA 154
strengths and disadvantages 113
technical aspects 112–113
see also Charité University Hospital
algorithm
dissecting aneurysm 191, 307,
308–310
assessment 311
extracranial VA, following BA
stenting 306–311
treatment 311
see also pseudoaneurysm
dissection 80, 190, 266–267, 294
aortic arch 81
assessment 191–193, 243–244,
249–250, 295–296
BA 262, 265, 267
diagnosis 294, 295
dissecting aneurysm 191–307
ICA 80
bilateral 238–244
case histories 183–193, 238–244,
251–260, 287–296
collateral pathways 238,
240–241, 254, 257, 260, 288,
291–293, 295–296
extracranial 287–296
iatrogenic 288, 295
secondary occlusion 183–193,
288, 293, 295
with fast recanalization 251–260
intracranial 266–267
management 191, 249
MCA 287, 288, 294
recanalization 191, 251–260
spontaneous 190, 243
traumatic 190
VA case history 245–250
Doppler, Christian A. 3, 3
Doppler effect 3–4
flow velocity and 4–5
Doppler-spectrum analysis 8
dot sign 79, 80
dynamic arterial spin labeling 59–60,
60
dynamic CTA 60
E
EC-IC Bypass Study 303–304
ECASS trials 179–180
echocardiography
transesophageal echocardiography
277
echo contrast delay test 251–252, 255,
260
ECST (European Carotid Surgery Trial)
86–88, 130, 132, 222
edema 162
elongations 76
ICA 76, 77, 289
embolism 138, 150, 151,165,168–169,
206, 271, 280–281, 326–327
cardioembolism 71, 177, 271, 275
see also microembolic signals
empty delta sign 336
epilepsy case history 143–148
external carotid artery (ECA) 13–14,
20
anatomy 20
identification 19,20,20
internalized flow signal 207
occlusion 90–91, 345, 347
stenosis 90–91, 91
extracranial–intracranial (EC–IC) by-
pass 142, 303–304, 320
complications 303–304
F
facial artery 14
facial paresis 133, 138, 269
fetal-type posterior cerebral artery
(FT-PCA) 102–103, 210, 211, 220,
232, 246, 274, 299, 301, 303,
304–305
fibromuscular dysplasia (FMD) 80, 81,
206,207
assessment 208
case histories 204–209
bilateral ICA dissection 238–244
clinical aspects 207–208
filter settings 12,12
FLASH technique 114, 114,115
flow dynamics 2–3
flow pattern 2, 2
flow velocity 2–3, 3,60
Doppler shift and 4–5
stenosis assessment 83, 83
Index378
flow void phenomenon 174
foramen ovale test 273
see also patent foramen ovale
Fourier analysis 3–4, 4, 5
free-floating thrombus 133–137
G
gain 11–12, 11, 12
gap sign 154, 349
giant-cell arteritis 228–229
assessment 229–230
case history 225–230
symptoms 229
treatment 229
H
Hagen–Poiseuille law 2, 2
halo sign, see dark halo sign
harmonic imaging 8, 9
headache 160
arteriovenous malformation 147
giant cell arteritis 225, 229
see also migraine
helical CT-angiography 193
he mat oma 190, 191, 192, 239,
249–250, 267, 294
subdural 302,303
hemiparesis 133, 165, 171, 176–178,
194, 204, 251, 253, 261, 319
hemorrhage
arteriovenous malformation and
146–147
hemorrhagic transformation, MCA
infarction 270, 273, 274
hereditary hemorrhagic telangiecta-
sia (HHT) 317, 317
high intensity transient signals(HITS),
see microembolic signals
homocysteine levels 157–158
Horner syndrome 190, 251
human immunodeficiency virus (HIV)
231–237
vasculopathy 236
hypercoagulability 135–136
hyperhomocysteinemia 157–158
hypertension 216
hyperventilation (apnoea test) 58
hypoplasia
A1-ACA-segment 32
P1-PCA-segment 38-39
VA 16 , 2 5 0 , 2 6 8
hypoventilation 58
hypoxia 84
I
iatrogenic dissection 288, 295
imaging modalities 7–8
infarction
BA stenting and 307, 307,310–311
border zone (BZI) 68–69, 185, 188 ,
191, 195, 196, 201, 251, 253, 259,
299, 338, 340, 345,348
lacunar 67, 67, 68
MCA 65–66, 66, 67,133–137,
149–155, 195,196
fibromuscular dysplasia and 205,
206, 206
hemorrhagic transformation
270, 273, 274
two-step 234
multiple 134, 135, 216, 217 , 222,
262, 262,266
PCA 156–159, 281, 281
PICA 169, 246, 246,248–249
pontine infarctions 70, 70,307
putaminal 273
small centrum ovale infarctions
(SCOI) 70, 70
territorial 65–66, 66, 67
mechanisms 326–327
thalamic 157
see also arterial ischemia; venous
ischemia
inferior petrosal sinus (IPS) 42, 48–49,
49
inferior sagittal sinus (ISS) 41
insonation angle 4–5, 5
insonation depth 9, 9, 10
cient collateralization 185, 253,
insuffi
259–260, 285–286, 320, 340
see also collateral pathways
internal carotid artery (ICA) 12,13,15,
18–19, 26–29
anatomy 18, 26–29
atherosclerosis 14, 341
C1/C2segment 28,29
C3/C4segment 28,28
C5segment 27,28
C6segment 27,27
CCA/ICA index 83
dilatation 14
dissection 80, 80
assessment 191–193, 243–244
bilateral 238–244, 239–243
case histories 183–193, 238–244,
251–260, 287–296
collateral pathways 238,
240–241, 254, 257, 260, 288,
291–293, 295–296
extracranial 287–296, 289–293
iatrogenic 288, 295
secondary occlusion 183–193,
288, 293, 295
with fast recanalization 251–260
elongations 76, 77, 289
fibromuscular dysplasia 81
ICA/ICA index 83
identification 18–19, 19 ,27
near occlusion
assessment 259–260
extracranial, case history
215–224
occlusion 89, 90,96,101, 103,
326–327
assessment 201–202
bilateral 194–203
case histories 194–203, 251–260,
319–330, 340, 344, 347
collateral pathways 105–108,
184 , 187–188, 196, 200,
202–203, 218–221, 223, 320,
325–326
hemodynamic effects 97
incidence 326
management 327–328
prognosis 327–328
secondary, in dissection 183–193,
288, 293, 295
subclavian steal phenomenon
319–330
stenosis 59,86–89, 96, 96
assessment 131–132
bilateral 243
case histories 128–132, 173 ,
204–209, 238, 243, 339, 340,
343, 345
clinical aspects 130–
collateral function tests 59–60
collateral pathways 238
grading 86–89, 88
in fibromuscular dysplasia and
Wegener granulomatosis
204–209
restenosis 216, 222, 223
ultrasound criteria 81–85, 82, 85
thrombus case study 133–137
internal cerebral vein (ICV) 41, 44, 45
internal jugular vein (IJV) 41, 42,
49–50, 49, 50
internalized flow signal 207
intima-media thickness (IMT) 77–78,
77, 78
intimal flap 248
intracranial stenoses, see stenosis and
also specific arteries
intracranial hemorrhage see hemor-
rhage
–29
131
Index 379
intramural hematoma 190, 239,
249–250, 267, 294
ischemia see arterial ischemia; venous
ischemia
ISCVT (International Study on Cere-
bral Vein and Dural Sinus Thrombosis) 335
ivy sign 174
L
lacunar infarction 67, 67, 68
laminar flow 2
lenticulostriate arteries (LSAs) 66, 344
leptomeningeal collaterals (LMCs)
103–104, 104, 10 5,109,343–345,
347
carotid-T stenosis 171
CCA occlusion 139, 141,142
ICA dissection 238, 240, 241, 293
ICA occlusion 107–108, 108, 184,
187, 188
MCA occlusion 179 ,231,234–235,
237, 269–271, 274–275,298
MCA stenosis 151, 152,171,297,
300–301, 303
leptomeningeal carcinomatosis 162
limb shaking 200, 327
lingual artery 13–14
lipoprotein(a) 158
lower pontine plane 25, 26
M
macaroni phenomenon 285
macroangiopathy 71–72, 226
magnetic resonance angiography
(MRA) 113–116, 349
BA occlusion 267
cerebral venous thrombosis 336
contraindications 115–116
dissecting aneurysms 311
fibromuscular dysplasia 208
historical development 113
moyamoya disease 174
near occlusion 224
stenosis assessment 154, 155
carotid siphon 214
MCA 153–154
VA 170
strengths and disadvantages
115 –116
subclavian steal phenomenon
329–330
technical aspects 114
contrast-enhanced 3 D MRA 115
FLASH 3 D GE technique 114, 114,
115
phase-contrast (PC) MRA 115
time-of-flight (TOF) MRA
114 –115 , 114
thrombus 137
VA ste n o s i s 20 2
see also Charité University Hospital
algorithm
magnetic resonance imaging (MRI)
113
contrast-enhanced perfusion anal-
ysis 60
dynamic spin labeling 59–60, 60
see also magnetic resonance an-
giography (MRA)
Martin–Spetzler scale 147
MATCH study 213
maxillary artery 14
media sign 80
metabolic coupling 57
testing of 57–59
metastases, leptomeningeal 162
microangiopathy 71, 72
microbubbles 8, 8,180
microembolic signals 72–75
detection of microemboli in patent
foramen ovale 74, 74
spontaneous microemboli 72–74,
72
midbrain plane 25, 25
middle cerebral artery (MCA) 7,11,15,
30–32
anatomy 30, 30
variants 30, 31
autoregulation testing 56
bifurcation 344
dissection 287, 288, 294
identification 30–
metabolic coupling testing 57–59
microembolic signals 72
near occlusion 340, 347
occlusion 79, 80,98,98,104,104,
209–210
ascending 231–237
assessment 236–237
asymmetry index (AI) 209
case histories 176–182, 231–237,
269–278, 297–305, 341
collateral pathways 109, 17 9 ,231,
234–235,237,269–275, 298,
303
hemodynamic effects 97
progressive 234, 297–305
thrombolysis 176–182
types of 236
32, 30, 31
with prominent early temporal
branch 269–278
stenosis 80,96–98, 98, 299
case histories 149–155, 171,
172 –17 3 ,287–305, 340,
344–345, 347
collateral pathways 151–152,171,
297, 300–301, 303
progressive 297–305
territorial infarction 65–66, 66,
case histories 133–137, 149–155,
195 , 196, 216, 320, 321
fibromuscular dysplasia and 206,
206
mechanisms 326–327
two-step 232, 234
migraine
dissection and 190, 243
PCA ischemia and 159
persistent foramen ovale and
276–277
stroke relationship 276–277
moyamoya disease case history
171 –17 5
assessment 174–175
clinical aspects 173–174
stages of 174
multiple infarctions 134, 135, 216, 217,
222, 262, 262,266
multislice computed tomography
(MSCT) 116–119 , 118,154
see also computed tomographic
angiography (CTA)
musical murmur 84
67
N
NASCET (North American Sympto-
matic Carotid Endarterectomy
Trial) 86–88, 109, 130, 132, 222,
327
near occlusion 223
ICA 215–224, 259–260
assessment 223–224, 259–260
treatment 222–223
MCA 340, 347
neurovascular coupling 56–57
testing 57, 57
New England Medical Center Poste-
rior Circulation Registry 168, 201,
310
NINDS rt-PA stroke Study Group trial
169, 178–179, 180
non-Hodgkin lymphoma 133, 135
nuclear magnetic resonance imaging
(NMRI) see magnetic resonance
imaging (MRI)
Index380
O
occipital artery (OccA) 14, 20, 21
occipitotemporal artery 235
occlusion 81
ACA 98–99, 341
BA 100, 100,165,166 ,168–169
assessment 267–268
case history 261–268
collateral pathways 262, 265–266
management 169
CCA 90
case histories 138–142, 347
clinical aspects 142
collateral pathways 139, 141,142
types 142
deep cerebral venous system 336
ECA 90–91, 345, 347
hemodynamic assessment 85–86
ICA 89, 90, 96, 101, 103 , 326–327
assessment 201–202
bilateral 194–203
case histories 194–203, 251–260,
319–330, 340, 344, 347
collateral pathways 105–108,
184 , 187–188, 196, 200,
202–203, 206, 218–221, 223,
320, 325–326
hemodynamic effects 97
management 327–328
prognosis 327–
secondary, in dissection 183–193,
288, 293, 295
subclavian steal phenomenon
319–330
intracranial 95–96
lateral sinuses 337
MCA 79, 80,98,98,104,104,
208–209
ascending 231–237
assessment 236–237
case histories 176–182, 231–237,
269–278, 297–305, 341
collateral pathways 109, 17 9 ,231,
234–235,237,269–275, 298,
303
hemodynamic effects 97
progressive 234, 297–305
thrombolysis 176–182
types of 236
with prominent early temporal
branch 269–278
morphological assessment 85
multilocular extra- and intracranial
occlusion 338–350
PCA 99, 99,104
recanalization 182, 191
328
SA 93–94, 326, 328
subclavian steal phenomenon
319–330
straight sinus 337
superior sagittal sinus 336
VA 9 2–93, 92, 93,100
collateral pathways 108, 108,168
distal, case history 245–250
secondary 226, 228
see also arterial ischemia; infarc-
tion; near occlusion; venous
ischemia
Ohm’s law of hemodynamics 55
ophthalmic artery (OA) 15, 28,29–30,
103–104
extracranial 29–30, 30
ICA occlusion effects 107, 107,206,
218–219, 221, 223
intracranial 29
oral contraceptives 158
oscillation test in fetal-type PCA
determination 40
P
paraneoplastic coagulopathy 134,
135–136
parietooccipital artery 235
patent foramen ovale 74, 74, 269–270
diagnosis 277
microembolic signals 74
migraine and 276–277
stroke relationships 275–277
treatment and 275–276
test 273
PC trial 276
peri-therapeutic imaging 124–125, 125
persistent foramen ovale see patent
foramen ovale
phase inversion harmonic imaging 8,
9
phase-contrast (PC) MRA 115
pial arteries 103
PICSS study 276
piezo-element 6
plaques 78–80, 78–80, 226, 227
calcified 79–80, 79
carotid bifurcation 226, 227, 233
CCA 217
high risk plaque identification 79
ICA 341
see also atherosclerosis; occlusion;
stenosis
soft plaque 132
pontine infarctions 70, 70
posterior cerebral artery (PCA) 12,16,
17, 38–39, 159
anatomy 38, 38
collateral pathways 269, 271, 274,
343, 344
fetal-type 102–103 , 210, 211, 220,
232, 246, 274, 299, 303,304–305
identification 38–39, 39
infarction 156–159, 281, 281
neurovascular coupling 56–57, 57
occlusion 99, 99,104
stenosis 99, 254
assessment 159
case history 156–159
clinical aspects 157–159
posterior communicating artery
(PCoA) 15, 16, 17, 39–40, 101–102,
349–350
anatomy 39–40
collateral pathways 106–109, 200,
202–203, 254, 291–293,
295–296, 305, 320, 325–326,
346–347,349–350
hypofunctional 281, 286
identification 40, 40
stenosis 240
variants 39, 285–286
posterior coronal plane 26, 27
posterior inferior cerebellar artery
(PICA) 15, 35, 35,108,108,248,265
infarction 169, 246, 246,248–249
power 11
power-mode imaging 7–8, 7
PROACT II study 180
protease inhibitors 236
protein S deficiency 236
pseudoaneurysm 191
pseudo-occlusion, see near occlusion
pulsatile heart function 54–55, 55
pulsatilitiy index 54-55, 60
pulse repetition frequency (PRF) 10,
10
R
recanalization 182, 191
following cerebral venous throm-
bosis 332, 336
following dissection 191, 251–260
following thrombolysis 278
resistance indices 60
RESPECT 276
restenosis 142
ICA 216, 222, 223
VA 16 9
retinal claudication 327
right-to-left shunt 270, 273
rt-PA thrombolysis see thrombolysis
Index 381
S
sample volume 9–10, 9, 10
second harmonic imaging 8, 9
seizures 143, 144, 146
shaking limb sign 200, 327
sigmoid sinus (SiS) 41
occlusion 337
sinus
carotid 13, 14, 19
cavernous (CS) 41–42, 48
confluence of 46
inferior petrosal (IPS) 42, 48–49, 49
inferior sagittal (ISS) 41
sigmoid (SiS) 41
occlusion 337
sphenoparietal (SpPS) 41, 47–48,
47, 48
straight (StS) 41, 45, 45, 46
occlusion 337
superior petrosal (SPS) 42, 48, 48
superior sagittal (SSS) 41,46–47, 46,
47
occlusion 336
thrombosis 336
transverse (TS) 41, 46–47, 47
occlusion 337
SITS-MOST study 180
Sjögren syndrome 133, 136
small centrum ovale infarctions (SCOI)
70, 70
soft plaque 132
SONIA (Stoke Outcomes and Neuro-
imaging of Intracranial Athero-
sclerosis) trial 153–154
sonothrombolysis 180–181
SPACE Collaborative Group study 130,
131
SPARC study 275
spectral broadening 84, 84
sphenoparietal sinus (SpPS) 41,
47–48, 47, 48
SSYLVIA (Stenting of Symptomatic
Atherosclerotic Lesions in the Ver-
tebral or Intracranial Arteries)
study 153, 310
stenosis 81–85
ACA 94, 98
case history 171, 17 2 , 173
ACoA 140
BA 99, 100, 99,307,308
carotid siphon 210–214, 344
assessment 213–214
carotid-T case history 171–
CCA 90, 90, 217
dissection and 191–192
175
distribution patterns following is-
chemia 79, 79
ECA 90–91, 91
functional 102, 203
hemodynamic assessment 82–84
blood flow velocity 83, 83
CCA/ICA index 83
ICA/ICA index 83
indirect 84–85, 85
spectral broadening 84, 84
ICA 59,86–89, 96, 96
assessment 131–132
bilateral 243
case histories 128–132, 173 ,
204–209, 220, 238, 243, 339,
340, 343, 345
clinical aspects 130–131
collateral function tests 59–60
grading 86–89, 88
in fibromuscular dysplasia and
Wegener granulomatosis
204–209
restenosis 216, 222, 223
ultrasound criteria 81–85, 82,
85
intracranial 94–95, 95
assessment 153–155
grading 95
MCA 80,96–98, 98, 299
case histories 149–155, 171,
172 –17 3
340, 344–345, 347
collateral pathways 151–152,171,
297, 300–301, 303
progressive 297–305
microembolic signals and 73
morphological assessment 81
area 82, 82, 83
diameter 82
multilocular extra- and intracranial
stenoses 338–350
PCA 99, 254
assessment 159
case history 156–159
clinical aspects 157–159
PCoA 240
SA 93–94, 199, 328
case history 279–286
Takayasu arteritis and 279–286
VA 91–92, 91,100
assessment 169–170, 2 0 2
balloon dilatation 166
bilateral 225–230
calcification 168
case histories 165–170 , 194 –203,
225–230, 279–286
collateral pathways 200
,287–296, 297–304,
management 201
restenosis 169
see also atherosclerosis
stenting
BA, extracranial VA pseudoaneur-
ysm case history 306–311
complications 310–311
ICA stenosis 131
near occlusion 223
intracranial atherosclerosis and
153
VA ste n o s i s 20 1
straight sinus (StS) 41, 45, 45, 46
occlusion 337
string of beads pattern 205, 206,207,
208, 238
string sign 222, 296
stroke 64–75, 168–169, 275–277
assessment 181–182
Charité University Hospital algo-
rithm 119, 120–122
HIV patients 235–236
homocysteine levels and 158
intracranial atherosclerosis and
152–153
migraine and 276–277
persistent foramen ovale and
275–277
prognosis 182
risk factors 157–158
thrombolysis case history
176 –182
TOAST classification 71–72
see also arterial ischemia; infarc-
tion; venous ischemia
stump-signal 140
Sturge–Weber syndrome (SWS) 317,
317
subclavian artery (SA) 15, 20–21, 21
occlusion 93–94, 326, 328
subclavian steal phenomenon
case history 319–330
stenosis 93–94, 199,328
with Takayasu arteritis, case his-
tory 279–286
subclavian steal phenomenon 93,94,
94, 326, 328–329
assessment 328–330
case histories 279–281, 285,
319–330
treatment 285
subdural hematoma 302, 303
superficial temporal artery (STeA) 14,
20, 20
dark halo sign 227, 229, 230
STeA–MCA bypass 298, 303
evaluation 305
Index382
superior cerebellar artery (SCA) 16,
37, 38
territorial infarction 166
superior petrosal sinus (SPS) 42, 48,
48
superior sagittal sinus (SSS) 41,46–47,
46, 47
occlusion 336
thrombosis 336
superior thyroid artery 13
sylvian vein 41
systolic window 5
T
Takayasu arteritis 81 , 142, 284–285
assessment 285
case history 279–286
diagnosis 284, 285
treatment 285
temporal arteriovenous malformation
(AVM)
case history 143–148
clinical aspects 146
territorial infarction 65–66, 66, 67
mechanisms 326–327
thalamic infarction 157
thalamic plane 25, 26
thrombocytosis 133, 136
thrombolysis 136
assessment 181–182
BA occlusion 168, 169
bridging technique 180
dissection and 191
intraarterial 180
MCA occlusion case histories
176 –182, 269
recanalization after 278
sonothrombolysis 180–181
thrombosis
CCA 340
cerebral venous (CVT) 123–124,124
assessment 336–337
case history 331–337
causes 335
treatment 335
MCA 234, 234,235
progressing in-situ thrombosis 234,
235
see also arterial ischemia; infarc-
tion; occlusion; thrombus; venous ischemia
Thrombosis in Brain Ischemia (TIBI)
grading system 95–96, 96,182, 209
thrombus 136–137, 151, 157, 2 71, 327
floating 133–137
formation 136
ICA, case history 133–137
management 136
see also thrombosis
time-of-flight (TOF) MRA 114–115 , 114
cerebral venous thrombosis 336
ICA dissection 192–193
near occlusion 223–224
occlusions 181, 349
BA 267
MCA 237
stenosis assessment 153, 154, 304
subclavian steal phenomenon 329
see also magnetic resonance an-
giography (MRA)
TOAST classification 71–
top-of-the-basilar-syndrome 169
transcranial Doppler (TCD)
autoregulation testing 56, 56
microembolic signals 72, 74
transducer 6–7, 6
transient ischemic attack (TIA) 65,
327
case histories 306
carotid siphon stenosis 210–214
CCA occlusion 138–142
ICA near occlusion 215, 216
moyamoya disease 171, 173, 174
VA ste n o s i s 168–169, 225–230
transtemporal bone window 25, 25,
27
transtemporal coronal planes 26, 27
transverse sinus (TS) 41, 46–47, 47
occlusion 337
traumatic dissection 190
triplex mode 8
TRUSCA (Thrombolysis with Ultra-
sound in Contradiction for Alteplase) study 181
turbulent flow 2–3
72
U
ultrasound delay test 59, 59,251–252,
255, 260
upper pontine plane 25, 26
V
valsalva maneuver 50, 50,74,74
vasculitis 81, 81
Charité University Hospital algo-
rithm 121–123, 123
see also Takayasu arteritis
vasomotor reactivity, see cerebro-
vascular reactivity
vein of Galen (VG) 41, 45, 45
vein of Labbé 41
vein of Trolard 41
venous anatomy 40, 41
extracranial 42–43, 42,49–51
flow velocities 53
intracranial 41–42, 41,43–49
see also sinus; specific veins
venous ischemia 74–75
venous stasis retinopathy 327
vertebral artery (VA) 13, 15, 15
anatomy 21–23, 22, 23,33
arteritis 229
calcifications 165, 166, 16 8
dissection case history 245–250
assessment 249–250
management 249
extracranial 21–23
V0/V1 segment 22–23, 23,91
V2 segment 22, 22,91–92
V3 segment 23, 23, 24,92
hypoplasia 15, 250, 268
identification 22, 22, 23, 34, 34, 35
intimal flap 248
intracranial 33–34
V4 segment 33–
165–170, 225–230
occlusion 92–93, 92, 93,100
collateral pathways 108–109,
108,168
distal, case history 245–250
secondary 226, 228
pseudoaneurysm, following BA
stenting 306–311
segment allocation 230
stenosis 91–92, 91,100
assessment 169–170, 2 0 2
balloon dilatation 166
bilateral 225–230
calcification 168
case histories 165–170 , 194 –203,
225–230, 279–286
collateral pathways 200
management 201
restenosis 169
with Takayasu arteritis 279–286
vertebral vein (VV) 43, 50–51, 51
vertigo 248
vesselwallpathology
atherosclerotic plaques 78–80
dissection 80, 80, 81
elongations 76, 77
fibromuscular dysplasia 80, 81
intima-media thickness (IMT)
77–78, 77, 78
vasculitis 81, 81
VISP (Vitamin Intervention for Stroke
Prevention) study 158
visual evoked Doppler (VED) 57, 57
34, 34, 35,
Index 383
W
wall pathology see vessel wall path-
ology
WASID (Warfarin Aspirin Sympto-
matic Intracranial Disease) study
152, 153, 154, 213
watershed infarction see border zone
infarction (BZI)
Wegener granulomatosis (WG) 208
case history 204–209
treatment 208
Windkessel function 54
Wyburn–Mason syndrome (WMS)
317, 317
Z
Zanette index 209