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- W2125331199 abstract "In 1892, William Osler, perhaps recording clinicopathological correlations from his personal observations, wrote, Portions of clot from an aneurism, thrombi from atheroma of the aorta or from the territory of the pulmonary veins may also cause blocking of the branches of the Circle of Willis (1). Now in autopsies of 239 patients with cerebral infarction and 261 with other neurological diseases, Amarenco et al. have confirmed Osler's assertion (2). After control. ling for disparities in age and heart weight (presumably evidence of hypertension) between the groups, they found significantly more ulcerated atherosclerotic plaques in the aortic arch in the stroke group, suggesting that these plaques are the source for emboli causing cerebral vascular events. Their evidence provides compelling reasons for clinicians to consider the aortic arch and the arteries su pplying the brain in their search for the etiology of cerebral infarction in their patients. It is unfortunate that the authors did not define precisely the depth and size of these ulcerated plaques nor do they report the prevalence of fissuring, subintimal hematoma, and the microscopic characteristics of the lesions they observed. For most clinicians, the diagnosis of embolism is made by inference (3), using (1) clinical presentation, (2) identified source for embolism, (3) evidence of emboli to other organs, and (4) cerebral infarctions in different vascular distributions as ind irect evidence. However, this logic may be misleading because the presence of a potential source is not proof of embolism (4). The means for reducing this uncertainty is becomingavailable through embolism detection USing Doppler sonographic techniques (5,6), which can" @default.
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- W2125331199 title "Editorial: Athrogenic embolism causing cerebral infarction" @default.
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- W2125331199 doi "https://doi.org/10.1016/s1052-3057(10)80206-x" @default.
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