Stroke is the third leading cause of death in the United States and is caused by carotid occlusive disease in 20–30% of cases. The majority of these will be due to disease at the carotid bifurcation. Only a minority of patients will have had warning symptoms of transient cerebral ischemia; most stroke patients are asymptomatic until the stroke occurs.
A bruit over the midportion of the neck may be a possible indicator of carotid artery stenosis. Its presence is not tantamount to carotid stenosis, but it may indicate the presence of a lesion involving the bulb of the carotid artery. Approximately 20% of patients with carotid bruits will have a hemodynamically significant stenosis of the carotid bulb. However, many patients with documented hemodynamically significant stenosis may not have a bruit. The absence of a bruit does not rule out underlying carotid disease. Patients with risk factors such as coronary artery disease, peripheral vascular disease, hypertension, diabetes, hyperlipidemia, and smoking are at risk for stroke or transient ischemic attacks (TIAs).
KeywordsInternal Carotid Artery Carotid Stenosis Carotid Bifurcation Carotid Artery Stenosis Asymptomatic Carotid
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