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recommendationchoosing-wisely· neurology / imaging· item cwus-aan-001

Don't perform imaging of the carotid arteries for simple syncope without other neurologic symptoms. Setting: simple syncope (faint) with no focal neurologic symptoms or signs Why: Occlusive carotid disease does not cause syncope; carotid imaging in simple syncope has no diagnostic yield, adds cost, and can trigger downstream cascades. Consider instead: history, examination, orthostatic vitals and a 12-lead ECG; reserve carotid imaging for suspected cerebrovascular disease with focal signs Source: American Academy of Neurology (Choosing Wisely, US, 2013).