Carotid

May 2017


Definition


The carotid arteries are the largest arteries in the neck. They supply blood to the brain. They are not perfectly symmetrical, the left carotid artery arising from the aorta, while the right common carotid arises from the brachiocephalic trunk. Each carotid artery then divides into internal vascular carotid arteries in the brain and external carotid arteries which irrigate the face. Carotid arteries have a predominant role: to carry oxygen to the brain. Therefore, in case of their obstruction, brain cells can suffer relatively quickly from a lack of oxygen, which can cause irreversible damage. The disease most commonly found in the carotid arteries is stenosis.

Symptoms


In case of complete and sudden obstruction of a carotid artery, often due to the migration of a blood clot that blocks the artery, the symptoms are:
- hemiplegia, i.e. the paralysis of the half of the body that is opposite to the affected carotid, affecting either the face and arm alone or the entire half of the body.
- sensory disturbances in the same areas;
- speech disorders;
- disturbances of vision opposite to the affected artery;
- in some cases, loss of consciousness.
Symptoms may regress spontaneously, - in less than 24 hours: this are called transient ischemic attacks (TIAs)- , or be continuous: this is called a cerebrovascular accident (CVA).
In moderate stenosis without complete obstruction, most often due to cholesterol deposits in the inner part of the membrane of the artery, there are generally few symptoms and thus the disorder is discovered while monitoring patients with factors of cardiovascular risk.

Diagnosis


In the case of sudden obstruction, the diagnosis is clinical, and a brain scan is done urgently. An MRI is sometimes performed as well as a cervical magnetic resonance angiography, which will show the occlusion in the artery. Typically, a Doppler ultrasound of the supra-aortic trunks will help locate the lesion. Treatment should be implemented urgently, often before the examinations. Other tests will be performed remotely, investigating the cause of the stenosis, often with the help of an electrocardiogram.

Treatment


The treatment of a carotid stroke is an emergency and requires hospitalization, monitoring of vital signs and levels of consciousness. The initial treatment is based on the administration of aspirin. In some cases, thrombolytic therapy for the destruction of the clot is possible. In the event of a discovery of carotid stenosis without stroke, two treatments are possible: either an endarterectomy, which consists of removing plaque if it is involved, or an angioplasty with a stent that will keep the artery dilated. This treatment is performed as soon as possible in the case of a carotid stroke.

Prevention


To prevent the occurrence of atherosclerosis in the arteries, or stenosis by migration of a clot, one must minimize all factors of cardiovascular risk. For this, a balanced diet is necessary, not too rich in animal fats and lipids. In addition, it is vital to limit alcohol consumption, to quit smoking, to maintain at activity at least 30 minutes of physical activity 3 times per week, fight against overweightness and follow a well-balanced treatment for hypertension, diabetes or high cholesterol.

Related

Published by Jeff. Latest update on June 22, 2013 at 05:58 AM by Jeff.
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