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February 23, 1963


JAMA. 1963;183(8):684-685. doi:10.1001/jama.1963.03700080092023

An increasing number of vascular lesions of the head and neck are surgically remediable; therefore, physical diagnostic techniques which serve to identify these lesions assume added importance. Cervical and cranial murmurs which may aid in identification and localization of vascular disease have been recently evaluated by Allen and Mustian.1 These investigators observed that the characteristic auscultatory finding in carotid stenosis consists of a sharply localized murmur which is ordinarily systolic in timing. Stenosis of the intracranial portion of the internal carotid artery produces a murmur heard best over the eye on the side of the narrowed vessel. Intensification or conversion to a continuous murmur occurs upon compression of the contralateral carotid artery, if this vessel is patent. Compression of the carotid proximal to the point of stenosis results in obliteration of the murmur. Complete occlusion of the carotid is not associated with a murmur, but a systolic or continuous

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