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March 1986

Asymptomatic Carotid Bruit and Stenosis: A Prospective Follow-up Study

Author Affiliations

From the Departments of Neurology, Massachusetts General Hospital, Boston (Dr Ford), and Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC (Ms Frye and Drs Toole and Lefkowitz).

Arch Neurol. 1986;43(3):219-222. doi:10.1001/archneur.1986.00520030011004

• We observed 70 patients with asymptomatic carotid bruits with and without stenoses for cerebral and myocardial ischemic events. Four patients developed transient ischemic attacks (TIAs) without subsequent cerebral infarctions; all of the TIAs occurred distal to vessels with greater than or equal to 50% stenoses. Three cerebral infarctions occurred, but only one was distal to a vessel with stenosis greater than or equal to 50%. Six myocardial infarctions occurred, predominantly in patients with previous myocardial infarctions, congestive heart failure, and left ventricular hypertrophy. Our results confirm previous reports that an asymptomatic carotid stenosis is more often complicated by a TIA than an unheralded cerebral infarction. Cerebral infarctions that do occur are often only marginally related to the carotid bifurcation lesion. In patients with asymptomatic carotid bruit and stenosis, myocardial infarctions occur more frequently and are more commonly the cause of death than cerebral infarctions.

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