January 1-December 1, 1993
The objectives of the study are (1) to describe a standard method for the clinical detection of a carotid bruit among adult Filipino patients with or without symptoms of cerebrovascular disease. (2) to determine the accuracy of this method in terms of sensitivity, specificity, and likelihood ratios in the detection of significant ipsilateral extracranial carotid stenosis. There were 100 patients, and hence, 200 arteries. The population was equally distributed according to sex and age. Of the 200 cases examined, forty-two percent had lateralizing symptoms, 38% had non-lateralizing symptoms, and the rest were symptomatic. Sixty-four cases were with carotid bruits (Group I) and 136 were without bruits (Group II) Eighty-four percent of Group I had diffuse bruits (Group lA) and Group I B had localized bruits. Group I and II differed because hypertension was noted higher in Group I. The following observations were made. (l) The standardized method of clinical detection of a carotid bruit results in high clinical agreement of the observers and may therefore be, reproduced by other physicians. (2) The absence of a carotid bruit is highly specific for the absence of significant carotid disease (moderate and severe stenosis) regardless of symptomatology. (3) The presence of a carotid bruit is not a good screening test for both moderate and severe grades of stenosis.