Detecting Carotid Occlusive Disease by Thermography

The ability of facial thermography to detect disease in the internal carotid artery was evaluated. Unilateral forehead cooling of 0.7 degrees C or greater was observed in 57% of 30 cases with angiographically proved stenosis. Two provocative tests, facial cooling and a head clamp, increased the sensitivity rate to 83%. The greatest overall sensitivity and specificity was obtained by using a head clamp especially designed to bilaterally occlude superficial temporal arteries. Facial thermography is a useful screening device in detecting carotid occlusive disease. However, the necessity to use a provocative test to increase the sensitivity to acceptable levels will probably limit its use to the screening of high-risk asymptomatic patients. It does not appear to be economically feasible in the mass screening of healthy individuals.