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We estimated the value of objective, computerized texture analysis of ultrasonic images in distinguishing carotid plaques associated with neurological ipsilateral symptoms (amaurosis fugax [AmF; n = 30], transient ischemic attack [TIA; n = 52], and stroke [n = 55]) from asymptomatic plaques (n = 51). We performed 3 case-control studies (1/symptom with asymptomatic plaques as control). On logistic regression, AmF was independently associated with severity of stenosis, percentage of pixels with gray levels 0 to 10 (PPCS1; measure of echolucency), and spatial gray level dependence matrices (SGLDM) information measure of correlation (IMC-1; texture); TIAs with PPCS1 (echolucency), SGLDM correlation, and skewness (both texture); and stroke with PPCS1, SGLDM correlation, and percentage of pixels with gray levels 11 to 20 (PPCS2; echolucency). The area under the curve of the regression-derived predicted probability for AmF, TIA, and stroke was 0.92, 0.82, and 0.85, respectively (all P < .001). Texture analysis can identify carotid plaques associated with a neurological event, improving the diagnostic value of echolucency measures. Texture analyses could be applied to natural history studies. [ABSTRACT FROM PUBLISHER]

Part III. Presents the management of and the role of several factors on stroke. Information regarding stroke; Discussion on thrombolysis, anticoagulant agents and prophylactic neuroprotection with pharmacologic agents; Relation with carotid endarterectomy, bypass surgery, carotid artery angioplasty and stenting; Treatment of cerebral hemorrhage; Means and possibilities of rehabilitation.

Part I. Focuses the epidemiology, clinical description and risk factors of stroke. Analysis of atheroma, carotid plaque echomorphology, carotid stenosis, ulcer, variations in surface deformability and dissection; Significance of cerebral collateral circulation; Conditions predisposing to cardioembolism and cerebral hemorrhage.