[Clinical significance of carotid and ocular bruits in cerebrovascular disease].
We investigated the clinical significance of carotid and ocular bruits in 250 consecutive patients with cerebrovascular disease (CVD). The incidence of bruits was compared with that in 100 age- and sex-matched neurological controls without CVD. In the cerebrovascular disease group, carotid bruits alone were found in 12 patients, both carotid and ocular bruits in 7, and ocular bruits alone in 2. Carotid bruits were found only in 3 controls. We then evaluated cerebrovascular disease in the 25 patients (16 men and 9 women) who had bruits. The patients ranged from 55 to 81 years in age (mean: 70.6 years). The patients with carotid bruits alone constituted the largest group, and those with ocular bruits alone were the smallest group. Carotid bruits were heard and abnormal blood flow was observed in 19/28 arteries of the 21 patients who underwent echo-flow studies. Carotid artery stenosis/occlusion was detected in 24/31 arteries (77%) in 23 patients who underwent digital subtraction angiography (DSA). Thus, the sensitivity was 0.77 and specificity of a carotid bruit 0.91, respectively. In 9/10 patients with unilateral ocular bruits, ipsilateral or contralateral carotid artery stenosis/occlusion was detected. Diminished cerebral blood flow was observed in 10/15 patients with bruits who underwent SPECT. Of these 8 had reduced cerebral blood flow ipsilaterally to the bruit. Blood flow was reduced in the carotid artery territory in all of the patients, and watershed reductions were commonest. Among the 25 patients, some showed neurological semiology of the vertebrobasilar territory in addition to that of the carotid territory.(ABSTRACT TRUNCATED AT 250 WORDS)
Hirose
Y
Y
Department of Neurology, Nagoya Daini Red Cross Hospital.
Yanagi
T
T
Ito
Y
Y
Yasuda
T
T
D000368:Aged; D000369:Aged, 80 and over; D001314:Auscultation; D002339:Carotid Arteries / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000175:diagnosis; D002561:Cerebrovascular Disorders / Q000175:diagnosis*; D005123:Eye / Q000098:blood supply*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity