CEA has emerged as a validated surgical procedure, which has proven to be of benefit in preventing stroke in either asymptomatic patients or those with ischemic symptoms. Prospective studies have showed a high risk of stroke in close temporal proximity to presenting ischemic symptoms. Another retrospective study found that the risks of stroke for patients with untreated TIAs were greatly increased compared with those of an age-adjusted group in the first 30 days after symptom onset . These studies suggest that patients with cerebral ischemic symptoms due to atherosclerotic carotid artery disease should be evaluated promptly after symptom onset for consideration of potential surgical intervention.
Controversy surrounding timing of surgical intervention for patients with recently completed stroke with neurological deficits is based on a study in which outcome was dismal after CEA . In patients in which a previously auscultated bruit has disappeared with acute total carotid occlusion, those with stroke following angiography and those with stroke following CEA due to vessel thrombosis should undergo emergent surgical intervention [31,32].
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.