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November 1955

Mechanism of Syncope Due to Unilateral Compression of Carotid Bifurcation

AMA Arch NeurPsych. 1955;74(5):556-558. doi:10.1001/archneurpsyc.1955.02330170090015

During the past six years we have had an opportunity to study many patients with partial or complete internal carotid occlusion in the neck.* It has been found that digital compression of the opposite carotid bifurcation results in syncope in the greatest majority of these patients (Table 1). Particularly important are the patients with partial occlusion of the internal carotid artery at the bifurcation who develop syncope on digital compression of the opposite carotid bifurcation (Table 2). The mechanical obstruction of the vessel results in an arrest or a decrease in carotid blood flow in the brain on the good side with consequent ischemia and syncope. This clinical response simulates the syncope described in the past as due to stimulation of a "hypersensitive carotid sinus" with a "cerebral type" of reaction.† Although our patients presented advanced cerebrovascular disease, it is quite likely that, even with less serious cerebrovascular atherosclerosis, patients

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