Ocular bruits in ischemic cerebrovascular disease

Area of Science:

• Neurology
• Vascular Medicine
• Diagnostic Imaging

Background:

• Atherothrombotic ischemic cerebrovascular disease poses significant health risks.
• Ocular bruits are an auscultatory finding potentially indicative of underlying vascular pathology.
• Understanding the etiology of ocular bruits is crucial for diagnosing and managing cerebrovascular disease.

Purpose of the Study:

• To investigate the causes of ocular bruits in patients with atherothrombotic ischemic cerebrovascular disease.
• To determine the prevalence of internal carotid artery siphon stenosis and contralateral carotid artery lesions in patients with ocular bruits.
• To explore potential racial differences in the distribution of carotid artery lesions.

Main Methods:

• Continuous-wave Doppler ultrasonography with spectrum analysis (Dopscan) was used to study 72 ocular bruits in 50 patients.
• Conventional angiography and digital subtraction angiography were performed in a subset of patients for detailed vascular imaging.
• Correlation of Doppler findings with angiographic results to identify specific vascular lesions.

Main Results:

• Internal carotid artery siphon stenosis ipsilateral to the ocular bruit was a highly prevalent finding.
• Contralateral internal carotid artery occlusion or tight stenosis accounted for a smaller proportion of ocular bruits.
• Ocular bruit was the sole auscultatory finding in 28% of the studied patients.

Conclusions:

• Siphon stenosis, either alone or in conjunction with contralateral carotid artery disease, is a primary cause of ocular bruits.
• Observed differences in lesion distribution compared to previous studies may indicate racial variations in carotid artery disease.
• Ocular bruit auscultation remains a valuable, albeit not exclusive, diagnostic sign in cerebrovascular disease assessment.