Abstract
Caplan reported the frontal artery sign as a bedside indicator of internal carotid artery occlusion. A 76-year-old man, who was normal except the previous history of transient ischemic attacks, drug-induced parkinsonism and multiple lacunar infarctions on CT scan, showed this sign in addition to the external carotid artery sign (ECS) of Olivarius.
His right superficial temporal artery was remarkably engorged (ECS), and its frontal branch had an anastomosis with the frontal artery of internal carotid origin. On palpation, the blood flow of the frontal artery was inverted (FAS).
On angiography, a complete obstruction of his right cervical ICA was confirmed and retrograde filling of intracranial ICA via ophthalmic artery was also observed.
The frontal artery sign is a good indicator of collateral flow in ICA occlusion, and is very diagnostic even if in an asymptomatic carotid occlusive disease.
