[Management of carotid bruits]

The search for a carotid bruit should be routine in any examination of an atheromatous subject or of a subject at risk. However, clinical examination is not sufficient and the authors stress the importance of non-invasive investigations, in particular, the doppler which has become part of current practice. Once the diagnosis of a carotid lesion has been made, the management depends on three conditions: --An understanding of the pathophysiology or its embolic origin; --A good definition of the clinical symptoms: asymptomatic, transient ischaemic attacks, cerebral softening; --A good knowledge of the spontaneous risk and the operative risk.