Syndrome of Carotid Artery Insufficiency

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Abstract
In recent clinical experience, this syndrome has been almost as common as the routine stroke. The total clinical spectrum encompasses asymptomatic carotid thrombosis to monocular blindness with contralateral hemiplegia. Falls in blood pressure of any cause is the major factor in production of transient symptoms. The diagnosis can be made on clinical grounds by palpation and auscultation of the carotids in the majority of cases. A localized continuous murmur over the carotid bulb represents a systolic and diastolic pressure deficit to the cerebral circulation and is a valuable clue to partial occlusion of the carotid bulb. In 100 consecutive hospital patients, localized systolic and continuous murmurs occur in 7% and 2% respectively and are closely correlated with existing neurological deficits. The neurological examination is usually negative and the only physical finding may be a systolic or continuous murmur over the partially obstructed carotid bulb contralateral to neurological symptoms.