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Carotid artery disease: Causes, symptoms, tests, and treatment

The most common type of carotid artery disease is atherosclerosis, or narrowing of the carotid arteries because of a build-up of fatty plaque.

Having carotid artery disease increases a person's risk of experiencing a stroke.

What are the carotid arteries?

The carotid arteries are two large blood vessels that supply oxygenated blood to the large, front part of the brain. This is where thinking, speech, personality, and sensory and motor functions reside. You can feel your pulse in the carotid arteries on each side of your neck, right below the angle of the jaw line.

How does carotid artery disease happen?

Like the arteries that supply blood to the heart - the coronary arteries - the carotid arteries can also develop atherosclerosis or “narrowing of the arteries” on the inside of the vessels.

Over time, the buildup of fatty substances such as cholesterol narrows the carotid arteries. This decreases blood flow to the brain and increases the risk of a stroke.

A stroke, sometimes called a “brain attack”, is similar to a heart attack. It occurs when blood flow is cut off from part of the brain. If the lack of blood flow lasts for more than 3 to 6 hours, the damage is usually permanent. A stroke can occur if:

  • The artery becomes extremely narrowed
  • There’s a rupture in an artery to the brain that has atherosclerosis
  • A piece of plaque breaks off and travels to the smaller arteries of the brain
  • A blood clot forms and obstructs a blood vessel

Strokes can occur as a result of other conditions besides carotid artery disease. For example, sudden bleeding in the brain, called intracerebral haemorrhage, can cause a stroke. Other possible causes of stroke include:

  • Sudden bleeding in the spinal fluid space -- subarachnoid hemorrhage
  • Atrial fibrillation
  • Cardiomyopathy
  • Blockage of tiny arteries inside the brain

What are the risk factors for carotid artery disease?

The risk factors for carotid artery disease are similar to those for heart disease. They include:

  • Age
  • Smoking
  • Hypertension ( high blood pressure) -- the most important treatable risk factor for stroke
  • Abnormal lipids or high cholesterol
  • Diet high in saturated fats
  • Insulin resistance
  • Diabetes
  • Obesity
  • Sedentary lifestyle
  • Family history of atherosclerosis, either coronary artery disease or carotid artery disease

Men under the age of 75 have a greater risk than women. Women have a greater risk over the age of 75. People who have coronary artery disease have an increased risk of developing carotid artery disease. Typically, the carotid arteries become diseased a few years later than the coronary arteries.

What are the symptoms of carotid artery disease?

You may not have any symptoms of carotid artery disease. Plaque builds up in the carotid arteries over time with no warning signs until you have a transient ischaemic attack (TIA) or a stroke.

Signs of a stroke may include:

  • Sudden loss of vision, blurred vision, or difficulty in seeing out of one or both eyes
  • Weakness, tingling, or numbness on one side of the face, one side of the body, or in one arm or leg
  • Sudden difficulty in walking, loss of balance, lack of coordination
  • Sudden dizziness and/or confusion
  • Difficulty speaking (called aphasia)
  • Confusion
  • Sudden severe headache
  • Problems with memory
  • Difficulty swallowing (called dysphagia)
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