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Over the past few years, several studies have shown that elastic properties of arteries independently correlate with the risk of various cardiovascular and cerebrovascular conditions. Furthermore, increased stiffness of the arterial tree appears to be an independent risk factor for atherosclerosis, end-stage renal disease, and aortic and carotid dissection. It has also been associated with increased mortality rate in patients with cerebrovascular disease. Due to its nonlinear elastic properties, the vascular tree has the ability to buffer pulsatile flow and thereby ensure constant tissue perfusion. The physiological function of the arterial tree is supported by the special organization of the arterial wall consisting of smooth muscle cells with collagen and elastin fibres. Due to special cell signalling which takes place during inflammation and the effect of other stimuli, remodelling of extra cellular matrix occurs. Subsequently, hypertrophy of collagen fibres and activation of metalloproteases occur and they eventually lead to the stiffening of elastic arteries. Using Doppler echography and other methods, it is possible to measure several stiffness indices, such as: pulse wave velocity, augmentation index, arterial compliance, beta index and elastic module, all of which have proved to be of predictive value for ischemic cerebral stroke. Increased stiffness of the carotid arteries is an important risk factor and a possible cause of ischemic events, which can be shown on brain MRI as white matter hyperintensities or leukoaraiosis.