[Cerebrovascular insufficiency (author's transl)].

Cerebrovascular insufficiency arises from multiple causes, including cardiovascular insufficiency and local obstacles to the blood flow in the "four brain vessels". These obstacles are caused by primary thrombosis, by embolism, or by stenosing or ectatic arteriosclerosis. As there are anastomoses in the extra- and intracranial vessels, a collateral circulation can arise when hemodynamic conditions (blood pressure etc.) are adequate; this is also necessary for the preservation of these collaterals in later stages. Since particular hemodynamic conditions (terminal and watershed zones) have particular roles, different patterns of infarction can arise. Local obstacles to the blood flow can be subjected to vascular surgery as a preventive measure or even for vital conditions. The details of cerebral blood flow and brain viability have not become completely clear from the results of modern experimentation. The setting up of research institutes to concentrate on arteriosclerosis and ischemia in collaboration with clinical centers devoted to coronary and cerebral infarction seems to be very necessary.