Elimination of subjective bruit with compression of temporal artery: new physical sign indicative of internal carotid artery occlusion.

A patient is presented with a right central retinal artery occlusion and subjective bruit over right ear. Digital compression of the right temporal artery eliminated the bruit and release reproduced the bruit. Carotid arteriogram showed bilateral internal carotid occlusion with a prominent right temporal artery. This sign reflects compensatory hyper-perfusion of the external carotid artery due to occlusion of ipsilateral internal carotid artery.