Carotid bruits: their significance in the cervical radicular syndrome

Routine physical examination of 600 patients referred with complaints of neck or shoulder pain included auscultation of both carotid and subclavian arteries. A treatment regimen including consideration of therapeutic cervical traction was precluded in 11 patients when unilateral carotid bruits were heard. Subsequent testing including radioisotopic carotid blood flow studies, and arteriography demonstrated 1 thoracic outlet syndrome, 1 arteriovenous malformation, 1 scarring secondary to radical neck dissection, 1 extrinsic pressure from an epidermoid carcinoma, 5 partial carotid occlusions secondary to intra-arterial plaque formation, and 2 normal carotid contrast studies. Successful surgery in all five of the stenotic patients and in the case of arteriovenous malformation aborted what might have otherwise been a less satisfactory outcome.