RT Journal
A1 Finucane TE
T1 CArotid disease and syncope
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2009
FD December 14
VO 169
IS 22
SP 2162
OP 2166
DO 10.1001/archinternmed.2009.447
UL http://dx.doi.org/10.1001/archinternmed.2009.447
AB 
Mendu and colleagues1 report on the yield of testing among older patients with syncope. They report no cerebrovascular cause of syncope, even though many of their patients had a history of stroke (16%), mental status changes (4%), symptoms suggestive of stroke (1%), and neurologic deficits on examination (6%). This makes sense because syncope, defined as the sudden, transient loss of consciousness with spontaneous recovery, cannot be caused by a cerebrovascular event (unless there are tremendous associated neurologic findings). Carotid disease is particularly implausible as a cause of syncope, yet 13% of patients underwent carotid ultrasound studies.