The significance of ocular bruits in ischaemic cerebro-vascular disease

Abstract

The significance of ocular bruits has been studied in a series of 18 patients presenting with symptoms of atherothrombotic ischaemic cerebro-vascular disease and studied angiographically.

Twenty-five ocular bruits were heard. They were nearly always associated with carotid bruits in the neck but were not simply the transmission of these bruits up the carotid; they were seldom related to a carotid siphon stenosis at least as a single cause. Most of them were 'augmentation bruits', pointing in over half the cases to a tight stenosis or an occlusion of the origin of the contralateral internal carotid artery and in 75% to widespread atheroma of both the carotid and vertebrobasilar systems.

The presence of an ocular bruit in such patients should thus be considered as a warning of a complex and sometimes critical haemodynamic situation and should therefore lead to the greatest caution in contemplating both angiography and surgery.