Recent reports by Johnson and Walker, Fisher, and Walsh and Smith,1 on occlusion of the internal carotid artery with its disastrous effects on the brain and eye offer explanations for a variety of cerebral and visual symptoms. Since the introduction of carotid arteriography by Moniz in 1927, the frequent occurrence of this lesion has been recognized, and its clinical diagnosis has been made possible. Before the use of arteriography, final diagnosis of occlusion of the internal carotid artery rested with the pathologist. I believe that the lesion can be detected by palpation alone.
The usual site of bifurcation of the common carotid artery into the external and internal carotid arteries is at the level of the hyothyroid interspace. Between this level and the angle of the mandible these two arteries lie close together, with the external carotid slightly anterolateral to the internal. At the level of the angle of
Dunning HS. DETECTION OF OCCLUSION OF THE INTERNAL CAROTID ARTERY BY PHARYNGEAL PALPATION. JAMA. 1953;152(4):321. doi:10.1001/jama.1953.63690040005007c