Management of asymptomatic carotid bruits

Asymptomatic carotid bruits may originate in the internal carotid artery from atherosclerotic plaques which predispose to strokes in certain individuals over the age of 40. Certain recently developed noninvasive screening tests are helpful in determining the hemodynamic significance of these bruits, which ultimately require arteriography to determine precise diagnosis and significance. If hazardous lesions are demonstrated, carotid endarterectomy may be recommended for selected patients without multiple risk factors to prevent the occurrence of ischemic cerebral episodes.