The heart pumps blood to the brain though large blood vessels in the neck known as the carotid arteries (one left, one right). When these vessels are affected by atherosclerosis they often become narrowed by plaque at a point below the level of the ear. When this happens, parts of the lining of the artery at the point of the narrowing may become disrupted and result in tiny clots developing and then travelling to the brain to cause stroke or mini stroke. Sometimes the artery may become completely blocked which may also result in stroke, or mini-stroke. The carotid arteries are examined for narrowing or blockage using a non-invasive ultrasound (duplex) examination (Figure).
Symptoms of carotid artery disease
- Loss of power in a limb or 2 limbs on the same side of the body.
- Slurred speech, weakness or drooping on one side of the face.
(When these symptoms are transient it is usually known as a min-stroke or a transient ischemic attack, when more long lasting disability occurs, it is known as stroke.)
- Temporary Loss of vision in one eye (amaurosis Fugax)
- Permanent Loss of vision in one eye (Retinal Ischaemia).
Treatment: The primary treatment or carotid artery disease is the same as for any complication of atherosclerosis, addressing risk factors and where necessary commencing medications. Whether or not the narrowed part of the artery requires surgery depends on age, sex, the degree of narrowing, and the symptoms. See interventions.
An ultrasound image demonstrating blood flow in the carotid artery