Carotid artery stenosis - one of the causes of stroke

Stroke is very common and is the third leading cause of death after cardiovascular disease and cancer. There are many causes of cerebral vascular accident, in which carotid artery stenosis is one of the most common causes (accounting for about 30% of cases).

Photos of carotid artery stenosis on magnetic resonance imaging (Photo: TTO)

However, carotid stenosis is rarely detected early, when a stroke occurs too late, all treatments are just support.

Why can carotid stenosis cause a stroke?

The carotid artery is quite large in size, located in the neck. Including the left carotid artery and the right carotid artery, we can feel their beats on both sides of the neck. Carotid arteries function to bring blood from the heart to nourish the brain.

Carotid artery stenosis is caused by atherosclerosis that attaches to the artery wall, where the carotid artery is narrowed, plaque and blood clots can be clogged in place, or self-rupture, forming small pieces of flow the blood comes to fill up some branch of the artery in the brain, causing the necrosis of a corresponding brain region that is fed by the artery branch.

Reason

The most common cause of carotid stenosis is atherosclerosis. The process of atherosclerosis has so far been understood as a process of physiological progression according to age and still unknown. However, it is found that there are risk factors associated with the formation and development of carotid atherosclerosis, namely: Age, usually only after age 50, the older the risk of carotid stenosis. increasing; hypertension; dyslipidemia; smoke; diabetes mellitus; besides obesity, sedentary lifestyle, many stresses, are also risk factors for carotid stenosis.

The more risk factors patients have, the more likely they are to have carotid stenosis.

Clinical symptoms of carotid stenosis

There may be no special manifestations, called asymptomatic carotid stenosis. The disease is detected at the general examination or examination because of another disease (cardiovascular, thyroid .).

Symptomatic carotid stenosis, which is a manifestation of transient ischemic or more severe is a stroke, with the following symptoms: Weakness or paralysis of the limbs; blurred or blind one eye, often transient (seconds, minutes, hours) then see normal; Voice disorder such as difficulty speaking or not speaking. These symptoms often occur suddenly.

Some patients have only one symptom, whereas patients have many symptoms at the same time. If self-healing completely before 24 hours, called transient ischemia; if surviving for more than 24 hours and usually for months, many years is called a true stroke.

Clinical examination by hearing in the patient's neck with a stethoscope, may then cause carotid Doppler ultrasound when in doubt. Carotid Doppler ultrasound is very valuable to determine whether it is narrow or not, how narrow it is .

In general, if the carotid stenosis is> 50%, then vascular surgery is required, depending on the case, the surgeon will recommend an X-ray or an angiogram from the carotid artery. Some other images such as CT-scans or cranial magnetic resonance imaging are also performed if needed

Methods for treating carotid stenosis

- Drug treatment: There are no drugs to reduce the condition of carotid artery stenosis, but only drugs to prevent the formation of blood clots in the place of carotid stenosis with the aim of preventing cerebral vascular accident in patients with Stenosis of the carotid artery. The most common is Aspirin.

- Surgical treatment: The goal of surgery is to remove atheroma to reduce the risk of stroke. Surgery only set when there is severe narrowing, specifically:

- For asymptomatic carotid stenosis, surgery is generally indicated for cases of narrowing> 80%.

- For symptomatic carotid stenosis, surgery is indicated when there is narrowing> 70% or milder stenosis (60%) but there is ulcer on atheroma.

- Carotid angioplasty: Started to apply since the 1990s, the safety and effectiveness of this method compared to classic surgery is still proving, in general this method is not popular.

Prevent

To prevent carotid stenosis, try to reduce and eliminate risk factors if any, such as: Treatment of hypertension, diabetes, dyslipidemia, quitting smoking, obesity . At the same time should also live close to nature, exercise a lot, exercise regularly .

For those who have carotid stenosis, these measures prevent patients from getting worse, but for those who do not have the disease, they will reduce the risk.