Meythaler H, Raithel D, Kneissl M
Klin Monbl Augenheilkd. 1978 Dec;173(6):794-801.
Obliterative processes of the carotid bifurcation can be a starting point for cerebral and especially retinal microemboli. Early diagnosis is essential in protecting such patients from a definitive insult, or a reduction of sight which can go as far as permanent blindness, whereas the amaurosis fugax being the most common ocular symptom of the internal carotid insufficiency. Due to the fact ca. 65%--75% of the patients with ocular symptoms of a carotid insufficiency show forms of amaurosis fugax or photopical sensations, this symptom complex, especially in combination with temporary contralateral hemiparalysis, has to be evaluated as a classical symptom of carotid stenosis until the contrary can be angiographically proven. Only during the last few years has it become apparent that these microemboli originate from ulcerous or verrucous beds of the carotid bifurcation. The discovery of the above connections was only made possible through the improvements in carotid angiography technique.