Its clinical manifestations result from neurological dysfunction in the territory of the internal carotid artery and its main branches, the anterior and middle cerebral arteries. They can be:
• Transient (TIAs), when lasting less than 24 h with full recovery.
• Reversible, when the symptoms disappear after 24 h without neurological deficit. Symptoms depend upon the involved area, giving rise to contralateral motor and/or sensory deficit. Dysphasia/aphasia may also arise following dominant hemisphere lesions.
• Crescendo TIAs, characterized by a succession of TIAs in a short period of time which could correspond to multiple embolization from active carotid plaques carrying an increased risk of permanent neurological deficit.
Fig. 2.2.3 Histologic examination of a carotid plaque removed by endarterectomy with cholesterol crystals surrounded by inflammatory infiltrate
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