Auscultation of cervical and ocular bruits in extracranial carotid occlusive disease: a clinical and angiographic study.

The clinical and angiographic features of cervical and ocular bruits were correlated in 50 consecutive patients with severe extracranial internal carotid artery occlusive disease. Cervical bruits, generally localized to the carotid bifurcation, were highly associated (P = 0.004) with "tight" (residual lumen less than or equal to 2 mm) internal carotid artery stenosis, but significantly less often with a widely patent or occluded internal carotid artery. Angiographic features of a "slow-flow" state through a patent, but "tight" stenosis were identified as the apparent explanation for the absence of bruit in some patients. A unilateral ocular bruit contralateral to the side of internal carotid artery occlusion occurred in 9 of 10 patients, more often than an associated cervical bruit, and was interpreted as a sign of augmentation flow.