CAROTID ARTERY MURMURS

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Abstract
In carotid artery insufficiency, when collateral circulation through the opposite carotid and the basilar system is inadequate, a continuous murmur is produced, usually over the carotid bulb, the most common site of involvement. Routine auscultation of the head and neck can reveal a localized continuous murmur over this partially occluded carotid bulb. This may be the earliest sign of carotid artery insufficiency. When the lumen narrows with atheromatous deposits in the carotid bulb, a systolic murmur appears first. As the lumen further narrows, and if collateral circulation is inadequate, a continuous murmur will appear. When a systolic or continuous murmur is detected over the carotid, one should be cautious not to attribute all central nervous system symptoms to carotid artery obstruction. Early surgery or anticoagulants may alleviate symptoms and prevent later complete thrombosis and irreversible neurological changes.

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