Clinical features

Why?

• A seventh of patients admitted with acute stroke, TIA or retinal stroke will have severe carotid stenosis (13%; 95% CI: 11% to 16%) ^a

A carotid bruit increases the risk of another stroke

Patient	Prognostic Factor	Outcome	CER	OR (95% CI)	NNF+ (95% CI)
retinal infarct a	carotid bruit independent	stroke at 4 years	10%	5.10 (1.30 to 20.0)	4 (2 to 38)

An ipsilateral carotid bruit makes severe carotid stenosis slightly more likely but is not diagnostic

Patient	Target Disorder and Reference Standard	Diagnostic Test	LR+ (95% CI)	Post-test Probability	LR- (95% CI)	Post-test Probability
recent or recurrent TIA or non-disabling stroke a (pre-test probability: 13%)	>70% carotid stenosis ( angiography )	ipsilateral bruit	1.6 (1.4 to 1.8)	19%	0.61 (0.54 to 0.69)	8%