Carotid Artery Disease

• Facts
• Risk Factors
• Symptoms
• Diagnosis

There are two carotid arteries (one on each side of the neck), which supply oxygen and glucose-rich blood to the large, front part of the brain where thinking, speech, personality, and sensory and motor functions reside. Like the blood vessels of the heart (coronary arteries), the carotid arteries also develop atherosclerosis, which is the buildup of plaque (fat and cholesterol deposits). Over time, this buildup narrows the artery, decreases blood flow to the brain and can lead to a stroke. A stroke occurs when brain cells (neurons) are deprived of the oxygen and glucose carried to them by blood. Oxygen and glucose are essential for neurons to function and survive. If the lack of blood flow lasts for more than 3 to 6 hours, the damage is usually permanent.

Facts:

Color Doppler Ultrasound of Right Common Carotid Artery

Approximately 25 percent of strokes are caused by carotid artery disease from atherosclerosis. A stroke can occur if:

• The artery becomes blocked
• A piece of plaque breaks off and travels to the smaller arteries of the brain
• A clot forms and blocks a narrowed artery

Risk Factors:

Controllable Risk Factors:

• High blood pressure
• Smoking
• Diabetes
• Heart disease (e.g., heart attack, heart failure)
• Artery disease outside the heart and the major vessels
• Obesity
• High blood cholesterol level
• Lack of exercise

Uncontrollable Risk Factors:

• Increasing age
• Gender
• Family history of stroke
• A relative with atherosclerosis
• Prior history of stroke and/or heart attack
• Race

Symptoms:

Many people do not have any symptoms from carotid artery disease. Some people may experience TIA or stroke. A stroke or “brain attack” is an injury to the brain caused by lack of oxygen. Stroke occurs in about 700,000 people a year in the United States. About 280,000 patients die each year from stroke-related causes. Transient Ischemic Attack (TIA), also called “temporary stroke” or “mini stroke”, is a warning sign that you are at high risk for experiencing a stroke. Because there are no specific symptoms of carotid artery disease, it is important to know these warning signs. If you have any of the warning signs of a stroke or TIA, it may be a sign of blockage in the carotid arteries.

Symptoms of a stroke or TIA:
During a stroke or TIA the blood flow to the brain is interrupted. Symptoms of stroke and TIA are very similar and depend on the area of the brain affected, how long your symptoms last, and the amount of the injury.

• Sudden numbness or weakness of the face, arm or leg, especially on one side
• Sudden confusion or dizziness
• Sudden trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, loss of balance or coordination
• Sudden, severe headache with no known cause
• Sudden trouble swallowing

Diagnosis:

Carotid artery disease may not have symptoms, so it is important for those at risk to have regular physical exams by their doctor. A doctor listens to the arteries in the patient’s neck with a stethoscope. An abnormal rushing sound, called a bruit (BROO-ee) may indicate that the patient has disease. If a bruit is discovered, the patient will likely undergo one of several available diagnostic procedures:                               

Angiography is the X-ray examination of the arteries and veins to diagnose blockages and other blood vessel problems.

Computed Tomography (CT) Angiography - an imaging procedure of the brain performed to determine areas of damage if it is suspected that a stroke has already occurred. This is a non-invasive test in which x-ray dye is administered intravenously, and the blood vessels are observed RANK CT imaging.      

Carotid Duplex Ultrasound - high-frequency sound waves are used to view the blood vessels in the neck and to determine the presence of narrowing in the carotid arteries.

Magnetic Resonance (MR) Angiography is a non-invasive diagnostic technique that creates an image of the blood vessels. A magnetic resonance (MR) scanner uses harmless but powerful magnetic fields and radio waves to create detailed images of the body's tissues.