Carotid Stenosis
Understanding Carotid Stenosis
Carotid Artery Stenosis is a medical condition characterized by the narrowing or blockage of the carotid artery, a significant artery located on either side of the neck. This blockage is typically caused by the accumulation of plaque, which consists of fatty cholesterol deposits. When plaque obstructs the normal blood flow through the carotid artery, it elevates the risk of a stroke. This process of plaque buildup is medically termed “atherosclerosis.”
The human body features two carotid arteries, one on each side of the neck. These large arteries play a crucial role in delivering blood to the brain, face, and head. In a healthy state, these arteries maintain a smooth and unobstructed passage, akin to clean pipes that facilitate the free flow of fluid, ensuring the uninterrupted distribution of blood, rich in nutrients and oxygen, to all parts of the body.
Carotid artery stenosis can develop in either one or both of the neck’s carotid arteries. Without proper medical attention, this condition can progressively worsen over time, leading to strokes that may result in severe complications, including fatalities.
Symptoms
Carotid artery stenosis has the potential to trigger a stroke, specifically an “ischemic” stroke. This type of stroke typically occurs when fragments of plaque or platelets adhering to plaque make their way to the brain, impeding the blood supply to a segment of the brain. In cases where this blockage becomes permanent, it leads to the deterioration of brain cells or neurons.
Additionally, individuals with carotid artery stenosis may experience a “transient ischemic attack” (TIA), often referred to as a “mini-stroke.” A TIA is characterized by a brief and temporary blockage of a small brain artery due to plaque buildup and/or platelets. Importantly, many people who experience a TIA are at an elevated risk of subsequently developing an ischemic stroke. As a result, it is imperative to seek prompt medical treatment to prevent cell damage and death in such situations.
Recognizing the symptoms of a stroke or TIA is crucial. These symptoms may include:
- Facial drooping on one side.
- Slurred speech or difficulty articulating words and communicating effectively.
- Sudden loss of vision in one eye, often described as a dark curtain descending over one’s field of vision.
- Numbness on one side of the body.
- Muscle weakness and a lack of strength on one side of the body.
It’s worth noting that carotid artery stenosis may not manifest with noticeable symptoms in cases where it has not yet caused a stroke.
Diagnosis
Carotid artery stenosis is often diagnosed following the occurrence of stroke-related symptoms. These symptoms serve as a red flag, prompting healthcare providers to conduct a thorough examination to uncover any potential blockages, which can lead to the identification of carotid artery stenosis. Additionally, the condition may come to light when healthcare professionals detect unusual sounds, such as a bruit (a whistling sound) or murmur, during a neck examination with a stethoscope.
To confirm the presence of carotid artery stenosis and gain insights into the size and location of the blockage, healthcare providers employ various diagnostic tests, including:
1. Ultrasound:
Also referred to as duplex ultrasound, this non-invasive test harnesses sound waves to generate images of the internal structures within your body. Conducted painlessly on the skin’s surface, ultrasound helps assess blood flow through your arteries and identifies areas where narrowing or blockages may exist.
2. Computed Tomography Angiography (CTA):
Utilizing a CT scanner, a device that employs X-rays to produce detailed images of your internal organs, this procedure offers an in-depth view of your carotid arteries. During the test, a contrast dye is introduced into your bloodstream to enhance the visibility of any blockages in the images. CTA is suitable even for individuals with pacemakers or pre-existing stents from other medical conditions.
3. Cerebral Angiography:
This diagnostic test involves the insertion of a catheter through minimally invasive means into your arteries to closely examine the blockage. Contrast material is directly injected into your arteries to provide a detailed view of artery specifics.
4. Magnetic Resonance Angiography (MRA):
Similar to a CT scan but without the use of X-rays, MRA produces intricate images of your arteries. It is a non-invasive imaging test that offers valuable insights into arterial conditions.
These diagnostic tests play a crucial role in confirming carotid artery stenosis and helping healthcare providers determine the extent and location of blockages, facilitating effective treatment planning.
Treatment
The primary objective in the treatment of carotid artery stenosis is to halt the advancement of the condition. This process commences with lifestyle adjustments, including adopting a healthy diet, engaging in regular exercise, and ceasing smoking. Additionally, a daily low-dose aspirin regimen may be recommended, accompanied by medications to manage blood pressure and cholesterol levels.
In more severe cases or instances where symptoms like transient ischemic attacks (TIAs) or strokes are present, healthcare providers may employ a surgical intervention known as carotid endarterectomy. This procedure involves the removal of plaque from the carotid artery through a surgical incision. Alternatively, a stent may be inserted through a large needle puncture and guided into the obstructed artery. This action serves to restore the artery to its normal dimensions while containing the plaque, preventing it from interfering with blood flow between the stent and the arterial wall. The determination of which procedure is most suitable for each individual with carotid artery disease is made by a vascular surgeon or specialist.
It’s important to note that not all cases of carotid stenosis necessitate surgical or interventional treatment, as these procedures carry inherent risks. Surgeons only recommend such procedures when the risks associated with severe stenosis and the potential for stroke outweigh the risks of the intervention itself.
Contact Us For An Appointment
The care team at North Carolina Neuroscience & Spine Center can help you decide on the treatment that's best for you. They specialize in minimally invasive surgery and are experienced in diagnosing and treating disorders and diseases, using the newest techniques for relieving pain and returning you to an active lifestyle. To make an appointment at North Carolina Neuroscience & Spine Center call 919-784-7550.
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