To the Editor. —We found the hypothesis of carotid plaque disruption proposed by Fisher et al1 interesting but at variance with our clinicopathologic data in Toronto, Canada. The authors emphasize surface events in carotid plaques, but we believe that events within the body of the plaque may be equally, or even more, important.We evaluated 71 consecutive symptomatic carotid plaques, and found 85% had large hemorrhages, about half of which were massive and destructive to the plaque. The hemorrhages were mainly deeply situated, rarely connected to the lumen, but occurred mainly at the "shoulder" of the plaque, often the site of rich vascularity. Intraluminal clot was microscopic and infrequent except in one occluded case. Intraplaque hemorrhages were often older than the elapsed time, since symptoms, apparently preceding clinical events by weeks, were presumably not directly related. One patient underwent bilateral carotid surgery, and the pathologic findings of the symptomatic
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
Instructions
Comments are moderated and will appear on the site at the discretion of the Archives of Neurology editors. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
and access these and other features:
Register Now
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.