[Pseudostenosis sounds and angiographic findings]

The suspicion of a carotid interna stenosis a short distance above the bifurcation because of a clear stenotic bruit on auscultation of the neck area proved to be unjustified in several cases, when angiography control was performed. In most cases, the superior thyroid artery was atypically developed (struma). An arterio-venous fistula of A. occipitalis was also wrongly suspected to be a carotid interna stenosis a short distance above the bifurcation, even when examined by Doppler ultrasonography, because of increased murmur of blood flow. When auscultating carotid bifurcation, proximal murmur from the heart must be excluded as well as venous hum. The later occurs mostly in hemodialysis patients and children. In approximately 10-20% of stenotic bruit cases in the neck area no stenosis could be detected. On the other hand, in more than 70% of all cases of carotid stenosis a short distance above the bifurcation no flow murmur could be detected by auscultation. The statistics show, however, that in every case of stenotic bruit, a generalised atherosclerosis must be suspected. Every such patient should therefore be carefully examined.