Cover -- Toole's Cerebrovascular Disorders, Sixth Edition -- Title -- Copyright -- Dedication -- Contents -- Contributor Affiliations -- Foreword -- Preface -- 1 A History of Cerebrovascular Disease since the Renaissance -- OBSERVATIONAL STUDIES OF ANATOMY AND PATHOPHYSIOLOGY -- CEREBRAL PERFUSION, METABOLISM, AND NEUROIMAGING -- STROKE PREVENTION AND INTERVENTION -- SURGICAL AND INTRAVASCULAR THERAPIES -- EVIDENCE-BASED MEDICINE AND STROKE ORGANIZATIONS -- CEREBROVASCULAR DISEASE IN CHILDREN -- ADDITIONAL INFORMATION -- REFERENCES -- 2 Interview and Examination -- INTERVIEWING THE PATIENT -- Cognitive Changes and Memory -- Loss of Consciousness -- Difficulties with Speech, Reading, or Writing -- Paralysis or Sensory Disturbances -- Depression -- Epileptic Seizures -- Visual Symptoms -- Amaurosis Fugax -- Central Retinal Artery Occlusion -- Hemianopia -- Diplopia -- Homonymous Visual Field Defects -- Cortical Blindness -- Oscillopsia -- Deafness, Vertigo, and Ataxia -- Headache -- Trauma -- Systemic Diseases -- Medications and Substance Abuse -- OPHTHALMOLOGICAL EXAMINATION -- Retinal Vascular Anatomy -- Ophthalmological Findings -- Central Retinal Artery Occlusion -- Retinal Hemorrhage -- Retinal Emboli -- Horner Syndrome -- NEUROVASCULAR EXAMINATION -- Inspection -- Palpation -- Arterial Blood Pressure -- Auscultation -- GENERAL EXAMINATION -- REFERENCES -- 3 Syndromes of Vascular Dysfunction -- CAROTID ARTERY DYSFUNCTION -- Applied Anatomy of the Carotid Artery -- Carotid Artery Anomalies -- Common Carotid Artery Occlusion -- Unilateral Internal Carotid Artery Stenosisand Occlusion -- Carotid Siphon Occlusion -- Bilateral Internal Carotid Artery Dysfunction -- Mechanisms of Arterial Occlusion -- OPHTHALMIC ARTERY -- Applied Anatomy -- Retinal Vascular Physiology -- Amaurosis Fugax -- Anterior Ischemic Optic Neuropathy.

Light-Sensitive Retinopathy -- MIDDLE CEREBRAL ARTERY -- Applied Anatomy of the Middle Cerebral Artery -- Middle Cerebral Artery Occlusion -- Bilateral MCA Lesions -- Transient Global Amnesia -- ANTERIOR CEREBRAL ARTERY -- Applied Anatomy of the Anterior Cerebral Artery -- Anterior Cerebral Artery Dysfunction -- Bilateral ACA Syndrome -- Combined ACA and MCA Occlusion -- ANTERIOR CHOROIDAL ARTERY -- Applied Anatomy of the Anterior Choroidal Artery -- Anterior Choroidal Artery Syndrome -- Bilateral Anterior Choroidal Artery Syndrome -- POSTERIOR COMMUNICATING ARTERY -- Anatomy of the Posterior Communicating Artery -- Dysfunction of the Posterior Communicating Artery -- DIFFERENTIAL DIAGNOSIS -- VERTEBRAL ARTERY DYSFUNCTION -- Vertebral Artery Anatomy -- Vertebral Artery Variations -- Mechanisms of Vertebral Artery Dysfunction -- BASILAR ARTERY DYSFUNCTION -- Examination of the Patient -- Cerebellar Infarction -- BASILAR ARTERY SYNDROMES -- Basilar Artery Occlusion -- Parinaud Syndrome -- Locked-in Syndrome -- Top of the Basilar Syndrome -- VERTEBROBASILAR BRANCH ARTERIES -- Posterior Inferior Cerebellar Artery -- Internal Auditory Artery -- Anterior Inferior Cerebellar Artery -- Superior Cerebellar Artery -- Mesencephalic Artery -- Branch Artery Syndromes -- Posterior Inferior Cerebellar Artery -- Medial Medullary Syndrome -- Anterior Inferior Cerebellar Artery Syndrome -- Pontine Paramedian Arteries -- Short Pontine Circumferential Arteries -- Long Pontine Circumferential Arteries -- Arterial Supply to the Midbrain -- Midbrain Paramedian Arteries -- Midbrain Long Circumferential Arteries -- POSTERIOR CEREBRAL ARTERY -- Relevant Anatomy -- Clinical Dysfunction of the PCA -- Bilateral PCA Infarction -- THALAMIC SYNDROMES -- ARTERIAL COMPRESSION SYNDROMES -- DIFFERENTIAL DIAGNOSIS OF BRAINSTEM STROKE -- PERSISTENT PRIMITIVE ANASTOMOSES.

STEAL SYNDROMES -- Pathophysiology -- Etiology of Steal Syndromes -- Clinical Features -- Diagnosis of Subclavian Steal Syndrome -- Course and Prognosis -- Management of Subclavian Steal -- ASSESSING SEVERITY -- REFERENCES -- 4 Pathophysiology of Ischemic Stroke -- PHYSIOLOGY OF CEREBRAL PERFUSION AND METABOLISM -- PATHOPHYSIOLOGY -- Hypoxia -- Ischemia -- Cerebral Autoregulation -- Oxygen Extraction Fraction -- BRAIN INFARCTION -- PATHOLOGIC FINDINGS -- HEMORRHAGIC INFARCTION -- BOUNDARY ZONE (HEMODYNAMIC) INFARCTION -- BIOCHEMICAL MECHANISMS -- The Ischemic Cascade -- NEUROGENIC MECHANISMS -- NITRIC OXIDE -- CARBON DIOXIDE AND OXYGEN -- INTRACRANIAL PRESSURE -- BRAIN-BLOOD BARRIER -- MICROCIRCULATORY COMPROMISE -- REPERFUSION INJURY -- THE ISCHEMIC PENUMBRA -- Imaging the Ischemic Penumbra -- PHYSIOLOGIC VARIABLES -- Temperature -- Blood Pressure -- Glucose -- Sleep -- Seizures -- CONCLUSION -- REFERENCES -- 5 Diagnostic Evaluation of Stroke -- GENERAL APPROACH TO PATIENT EVALUATION -- LABORATORY STUDIES -- CRANIAL COMPUTED TOMOGRAPHY -- CT ANGIOGRAPHY -- BRAIN MRI -- MAGNETIC RESONANCE ANGIOGRAPHY -- EMISSION TOMOGRAPHY -- Positron Emission Tomography -- Single Proton Emission Computed Tomography -- CATHETER ANGIOGRAPHY -- LUMBAR PUNCTURE -- ULTRASOUND -- Carotid Duplex Ultrasound -- Transcranial Doppler -- BIOMARKERS IN CEREBROVASCULAR DISEASE -- GENETIC TESTING IN CEREBROVASCULAR DISEASE -- REFERENCES -- 6 Transient Ischemic Attacks -- DEFINITION -- EPIDEMIOLOGY AND NATURAL HISTORY -- PATHOGENESIS OF TIAS -- Microembolism -- Vasospasm -- Hypotension -- Hematologic Causes -- Head and Body Positions -- Reversal of Cephalic Blood Flow -- Other Abnormalities of the Vessel Wall -- CLINICAL FEATURES -- Symptom Onset -- Duration of Symptoms -- Headache -- Frequency of Attacks -- Neurovascular Examination -- Risk Stratification and Prognosis.

DIFFERENTIAL DIAGNOSIS -- Systemic Disease -- Intracranial Disease -- DIAGNOSTIC EVALUATION -- MEDICAL MANAGEMENT -- Platelet Antiaggregant Therapy -- Anticoagulant Therapy -- Regimen for Warfarin Therapy -- Blood Pressure Medications -- SURGICAL-ENDOVASCULAR MANAGEMENT -- COURSE AND PROGNOSIS -- REFERENCES -- 7 Atherosclerosis of the Cervicocranial Arteries -- CLINICAL MANIFESTATIONS OF ATHEROSCLEROSIS -- RISK FACTORS FOR ATHEROSCLEROSIS -- Arterial Hypertension -- Cholesterol and Lipoproteins -- Homocysteine -- PATHOLOGY OF ATHEROSCLEROSIS -- Site of Predilection and Age of Occurrence -- Visual Appearance -- Microscopic Pathology -- PATHOGENESIS OF ATHEROSCLEROSIS -- Thrombogenesis -- Hemodynamic Implications -- Formation of Atherosclerosis -- Boundary Layer Separation -- Stress Proteins -- EVALUATION FOR ATHEROSCLEROSIS -- MANAGEMENT OF ATHEROSCLEROSIS -- Risk Factor Reduction -- Risk Factor Reduction -- Medical Management of Atherosclerosis -- Platelet Antiaggregant Therapy -- Carotid Endarterectomy -- Stenting of the Cervicocerebral Vessels -- REFERENCES -- 8 Embolism and Stroke -- CARDIOGENIC CEREBRAL EMBOLISM -- Rhythm Disorders -- Sick Sinus Syndrome -- Atrial Fibrillation -- Myocardial Infarction -- Cardiac Failure -- Congenital Heart Disease -- Atrial Septal Lesions -- Valvular Heart Disease -- Infective Embolism -- Rheumatic Valvular Heart Disease -- Mitral Valve Prolapse -- Nonbacterial (Marantic) Thrombotic Endocarditis -- Libman-Sacks Endocarditis -- Prosthetic Heart Valves -- Cardiac Tumors -- ARTERY-TO-ARTERY EMBOLISM -- AORTIC ATHEROSCLEROTIC PLAQUE -- EMBOLISM DURING CARDIAC PROCEDURES -- FOREIGN BODY EMBOLISM -- FAT EMBOLISM -- AIR EMBOLISM -- Nitrogen Bubbles (Bends) -- Neoplasm-Related Embolism -- PATHOPHYSIOLOGY OF CEREBRAL EMBOLISM -- PATHOLOGICAL FINDINGS -- DIAGNOSIS OF CEREBRAL EMBOLISM -- PROGNOSIS AND CLINICAL COURSE.

REFERENCES -- 9 Lacunar Strokes and Hypertensive Encephalopathy -- ARTERIAL HYPERTENSION -- Pathophysiology -- Diagnosis of Presymptomatic Hypertension -- Management of Presymptomatic Hypertension -- LACUNAR INFARCTION -- Clinical Features of Lacunes -- Pure Sensory Stroke -- Dysarthria-Clumsy Hand Syndrome -- Ataxic Hemiparesis -- Sensorimotor Stroke -- Diagnostic Evaluation -- Management of Lacunar Infarction -- Course and Prognosis of Lacunae -- HYPERTENSIVE ENCEPHALOPATHY -- Etiology and Pathogenesis -- Pathologic Findings -- Signs and Symptoms -- Differential Diagnosis -- Laboratory Findings -- Course of Hypertensive Encephalopathy -- Management of Hypertensive Encephalopathy -- REFERENCES -- 10 Inflammatory Angiopathies and Stroke -- GIANT CELL ARTERITIS -- Clinical Features -- Laboratory Findings -- Pathologic Findings -- Diagnosis and Management -- TAKAYASU ARTERITIS -- Clinical Features -- Laboratory Findings -- Pathologic Findings -- Course and Prognosis -- Management -- POLYARTERITIS NODOSA -- Clinical Features -- Laboratory Findings -- Pathologic Findings -- Management and Prognosis -- PRIMARY ANGIITIS OF THE CNS -- Clinical Features -- Laboratory Findings -- Pathologic Findings -- Diagnosis and Management -- WEGENER GRANULOMATOSIS -- Clinical Features -- Pathologic Findings -- Laboratory Findings -- Management -- HYPERSENSITIVITY VASCULITIS -- ARTERITIS CAUSED BY INFECTION -- Infectious Embolism -- Meningitis -- Herpes Infections -- Human Immunodeficiency Virus -- Syphilis -- Fungal Infection -- Neuroborreliosis (Lyme Disease) -- SYSTEMIC LUPUS ERYTHEMATOSUS -- Clinical Features -- Laboratory Findings -- Pathologic Findings -- Management -- BEHÇET DISEASE -- Pathology -- Diagnosis -- Treatment -- OTHER CNS VASCULITIDES -- THROMBOANGIITIS OBLITERANS (BUERGER DISEASE) -- REFERENCES -- 11 Hematological Disorders and Hypercoagulable States.

HEMOGLOBIN DISORDERS.