Stroke and Carotid Artery Stenosis
Carotid arteries are blood vessels located on each side of the neck, branching out from the aorta at the chest area. They supply blood to the forebrain, which is the majority of the brain. Carotid artery stenosis can lead to a lack of blood to the brain, resulting in facial droop, slurred speech, weakness in arms and legs, or difficulty speaking or listening.
Carotid ultrasound can produce a picture of carotid arteries and detect atherosclerotic plaque on the wall of carotid arteries. Patients may need a carotid ultrasound if they:
- Have hypertension.
- Have diabetes.
- Have hyperlipidemia.
- Had a transient ischemic attack.
- Smoke or are close with someone who smokes.
- Have family members who have a stroke or heart disease.
- Are diagnosed with carotid bruit.
- Had transient monocular blindness.
- Carotid arteries supplying blood to the brain also branch out to supply blood to the eyes. Therefore, a partial or complete loss of vision may be due to broken-free blood clots or cholesterol from the carotid or internal carotid arteries.
Diagnosis
Diagnosis with CTA brain and neck or MRA brain and neck can picture the physical structure of crucial arteries. However, they produce less detailed images of abnormalities inside the arteries compared to a carotid ultrasound.
Treatment
- Cut back on food that causes fat accumulation in the arteries.
- Take antiplatelets and medicines for pre-existing conditions to lower the risk of developing carotid artery stenosis.
- For severely narrowed internal carotid artery or carotid bulb that affects the brain, a physician may order CT Perfusion Brain to measure blood flow to the brain and consider the following treatments.
- Carotid artery stenting (CAS) is a transfemoral catheterization. Equipment is inserted and guided through the femoral artery to the blockage. Then, an angiogram is performed to detect stenosis in the carotid artery. An angioplasty balloon widens the blocked artery and places a stent to keep it open. The benefit of CAS is the short recovery time as it is a non-surgical procedure. However, its disadvantage is that it may not fully expand the blocked carotid artery.
- Carotid endarterectomy (CEA) is a surgery to remove plaque from the wall of the blocked carotid artery. A surgeon may expand the carotid artery with a vein wall. The advantage of CEA is that it can widen the blocked carotid artery more. However, this procedure may require general anesthesia and a longer recovery time.
