Carotid Artery Disease

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  • Sudden loss of vision or blurred vision in one or both eyes
  • Weakness and/or numbness on one side of the face, or in one arm or leg
  • Slurred speech, difficulty talking or understanding what others are saying
  • Loss of coordination
  • Dizziness or confusion
  • Difficulty swallowing

A TIA is a medical emergency, since it is impossible to predict if it will progress into a major stroke. If you or someone you know experiences these symptoms, get emergency help (Call 9-1-1 in most areas). Immediate treatment can save your life or increase your chance of a full recovery.

TIAs are strong predictors of future strokes; a person who has experienced a TIA is 10 times more likely to suffer a major stroke than someone who has not experienced a TIA.

What is a stroke?
A stroke, or "brain attack," occurs when a blood vessel in the brain becomes blocked or bursts. The brain cannot store oxygen, so it relies on a network of blood vessels to provide it with blood that is rich in oxygen. A stroke results in a lack of blood supply, causing surrounding nerve cells to be cut off from their supply of nutrients and oxygen. When tissue is cut off from its supply of oxygen for more than 3 to 4 minutes, it begins to die.

A stroke can occur if:

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

A stroke also can occur as a result of other conditions, such as sudden bleeding in the brain (intracerebral hemorrhage), sudden bleeding in the spinal fluid space (subarachnoid hemorrhage), atrial fibrillation, cardiomyopathy, or blockage of the tiny arteries inside the brain.

How is carotid artery disease diagnosed?
There may not be any symptoms of carotid artery disease. If you are at risk, it is important to have regular physical exams

A doctor will listen to the arteries in your neck with a stethoscope. An abnormal rushing sound, called a bruit (pronounced BROO-ee), may indicate carotid artery disease. However, bruits are not always present when there are blockages, and may be heard even when the blockage is minor.

Diagnostic tests include:

  • Carotid duplex ultrasound: An imaging procedure that uses high-frequency sound waves to view the carotid arteries to determine if there is narrowing.
  • Carotid angiography (carotid angiogram, carotid arteriogram, carotid angio): During this invasive imaging procedure, a catheter (thin, flexible tube) is inserted into a blood vessel in the arm or leg, and guided to the carotid arteries with the aid of a special X-ray machine. Contrast dye is injected through the catheter while X-rays of the carotid arteries are taken. This test may be performed to evaluate or confirm the presence of narrowing or blockage in the carotid arteries, determine the risk for future stroke and evaluate the need for future treatment, such as angioplasty or surgery.
  • Magnetic resonance angiogram (MRA): MRA is a type of magnetic resonance image (MRI) scan that uses a magnetic field and radio waves to provide pictures of the carotid arteries. In many cases, MRA can provide information that cannot be obtained from an X-ray, ultrasound, or computed tomography (CT) scan. This test can provide important information about the carotid and vertebral arteries and the degree of stenosis.
  • Computerized tomography (CT Scan): a CT of the brain may be performed if a stroke or TIA is suspected to have already occurred. During a CT scan, X-rays pass through the body and are picked up by detectors in the scanner, which produce three-dimensional (3D) images on a computer screen. Depending on the type of scan you need, a contrast material might be injected intravenously (into a vein) so the radiologist can see the body structures on the CT image. This test may reveal areas of damage on the brain.
  • Computed tomography angiogram (CTA): A test that uses advanced CT technology, along with intravenous (IV) contrast material (dye), to obtain high-resolution, 3D pictures of the carotid arteries. CTA images enable physicians to determine the degree of stenosis.

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Last Updated: 9/22/2008

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