[Risk factors of transient cerebral ischemic episodes: hyperfibrinogenemia and carotid histopathology]

Risk factors may play a fundamental role in the evolution from a stable to a vulnerable plaque. In particular, the hyperfibrinogenemia, independently from other risk factors, influences the natural history of cerebrovascular disease modifying the histologic composition of atherosclerotic plaques and precipitates carotid thrombosis resulting from rupture of the plaque. Determination of plasma fibrinogen may help to identify a subset of patients at high risk for a rapid progression of carotid atherosclerosis and related clinical events. We suggest that these patients may benefit of an earlier surgical intervention even if the degree of carotid stenosis is not severe.