When faced with a patient who may have had a stroke or transient ischaemic attack (TIA), one needs to ask oneself some simple questions: was the event vascular?; where was the brain lesion, and hence its vascular territory?; what was the cause? A careful history and focused physical examination are essential steps in getting the right answers. Although one can learn a great deal about the state of a patient’s arteries from expensive vascular imaging techniques, this does not make simple auscultation of the neck for carotid bruits redundant. In this brief review, we will therefore define the place of the bruit in the diagnosis and management of patients with suspected TIA or stroke.
WHY ARE CAROTID BRUITS IMPORTANT?
A bruit over the carotid region is important because it may indicate the presence of atherosclerotic plaque in the carotid arteries. Thromboembolism from atherosclerotic plaque at the carotid artery bifurcation
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