Headaches, seizures, monocular blindness, pareses, and unconsciousness, receding and recurring, and finally progressing to hemiplegia, should lead to the suspicion of stenosis or occlusion of a carotid artery. Valuable diagnostic information in such cases is obtained by arteriography and by applying digital pressure to the unaffected carotid, but both procedures have inherent dangers. A safer procedure, here described, consists in observing the central artery of the retina by ophthalmoscopy while measured pressures are applied to the eyeball. As the pressure is increased, pulsations usually appear in the artery between 20 and 70 Gm. of pressure and usually cease between 60 and 130 Gm. Data are given on five cases of proved occlusion of the internal carotid, and two case histories illustrate typical findings. The test is neither painful nor dangerous. Its use should be encouraged, for an early diagnosis greatly improves the outlook for successful surgery.
Wood FA, Toole JF. CAROTID ARTERY OCCLUSION AND ITS DIAGNOSIS BY OPHTHALMODYNAMOMETRY. JAMA. 1957;165(10):1264–1270. doi:10.1001/jama.1957.02980280038009
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