Carotid Disease

Carotid artery disease and stroke.

A 'stroke' is the common name for the neurological symptoms that are caused by interruption of the blood supply to the brain. These include weakness of the arms or legs, slurring of speech, drooping of one side of the face and visual disturbances. These can be either permanent or temporary. A 'transient ischaemic attack' or TIA occurs when symptoms resolve with 24 hours. There are two causes for a stroke: blockage of a blood vessel (ischaemic) or bleeding on the brain (haemorrhagic).

Diagnosis and investigation

Everybody who has had a stroke will have urgent investigations to find out why this has happened. This will include blood tests, a brain scan and a scan of the blood vessels in the neck. In some cases it will be discovered that one or both of the main arteries to the brain (the carotid arteries) are narrowed by a build up of atherosclerosis, caused by a combination factors such as age, smoking, high blood pressure, high cholesterol, male gender and genetic susceptibility. If the diseased area suddenly becomes unstable, or it ruptures into the bloodstream, small fragments can break off and travel to the brain. Thesemay lodge in a small artery in the brain,causing an area of tissue to become starved of oxygen (ischaemic).The area of the brain where this occurs will determine the symptoms that are experienced. After an event such as this, there is a 10-15% of a second, major stroke in the next 4-6 weeks, and the recommended treatment is surgery to remove the disease from the artery. This operation is called a carotid endarterectomy, and should be performed within two weeks of the onset of symptoms whenever possible.


Treatments


The medical information provided here is intended solely for patients of the London & Surrey Vascular Clinic, it is general information only and should not be used as a substitute for personal advice received when consulting your own surgeon face-to-face.

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