Carotid artery disease occurs when the major arteries in the neck become narrowed or blocked. These arteries, called the carotid arteries, supply the brain with blood. The carotid arteries extend from your aorta in the chest to the brain inside the skull. Carotid artery disease is a serious health problem because it can cause a stroke.

A stroke occurs when a blood vessel carrying oxygen and nutrients to the brain is blocked by a clot or bursts, causing the brain to starve. If deprived of oxygen for even a short period of time, the brain nerve cells will start to die. Once the brain cells die from a lack of oxygen, the part of the body that section of the brain controls is affected through paralysis, language, motor skills, or vision.

Strokes caused by blood clots that block the artery are ischemic (is-KEM-ik) strokes. This is the most common type, accounting for 70-80 percent of all strokes.

When a blood vessel ruptures, it causes a bleeding or hemorrhagic (hem-o-RAJ-ik) stroke. Once the brain cells die from a lack of oxygen, the part of the body controlled by that section of the brain is affected. Strokes can cause paralysis or language, motor skills or vision difficulties.

Carotid artery disease may not cause symptoms in its early stages.Unfortunately, the first sign of carotid artery disease could be a stroke. However, you may experience warning symptoms of a stroke called transient ischemic attacks, or TIAs.

• Sudden weakness or numbness in the face or limbs, often on just one side of the body
• The inability to move one or more of your limbs
• Trouble speaking or understanding speech
• Sudden trouble seeing in one or both eyes
• Dizziness or loss of balance
• A sudden, severe headache with no known cause

A mini-stroke is a warning sign that you're at high risk of having a stroke. You shouldn't ignore these symptoms. About one-third of people who have mini-strokes will later have strokes. Getting medical care can help find possible causes of a mini-stroke and help you manage risk factors. These actions might prevent a future stroke.

There are a number of diagnostic exams that can be performed to determine if someone has had a stroke or is at risk for having one.

• Computed tomography (CT)The first diagnostic test performed in the emergency room is usually a CT scan. CT uses computers to generate detailed pictures of the brain, and can confirm the diagnosis of stroke and tell whether the stroke is caused by a hemorrhage in the brain.

• Magnetic resonance imaging (MRI)is a diagnostic test which may be performed to identify and further localize the site of the stroke and find the source. It may be able to quickly identify the area deprived of sufficient blood flow and guide further therapy. In the MR Image, the arrow points to the area affected by a stroke.

• AngiographyAn angiogram is an X-ray in which a contrast agent, or dye, is injected into a vein to highlight the blood vessels. With this exam, radiologists can pinpoint the exact location of blockage or bleeding in the brain. Angiography also is used to guide thin tubes called catheters to the site of the problem and administer treatments.

Treatments for carotid artery disease may include lifestyle changes, medicines, and medical procedures. The goals of treatment are to stop the disease from getting worse and to prevent a stroke

Making lifestyle changes can help prevent carotid artery disease or keep it from getting worse. For some people, these changes may be the only treatment needed:

• Follow a healthy diet to prevent or lower high blood pressure and high blood cholesterol and to maintain a healthy weight.
• Be physically active. Check with your doctor first to find out how much and what kinds of activity are safe for you.
• If you're overweight or obese, lose weight.
• If you smoke, quit. Also, try to avoid secondhand smoke

Patients whose blockages are mild to moderate can often manage their disease by making lifestyle changes such as quitting smoking and by working with their doctors to take care of related conditions such as diabetes, high blood pressure, and high cholesterol. Doctors will monitor the disease and initiate other treatments if the disease begins to progress. They may also prescribe blood-thinning drugs or other medications

Symptomatic Carotid Artery Stenosis

The severity of carotid artery stenosis strongly correlates with the relative risk of stroke. Through the removal of atherosclerotic plaques, carotid endarterectomy (CEA) restores cerebral blood flow and reduces the risk of cerebral ischemia. While medical therapy clearly plays a role in the management of atherosclerosis in general and carotid artery disease in particular, the results from three major prospective contemporary studies provide compelling evidence for the benefit of CEA versus medical therapy alone. When performed by experienced surgeons, CEA, most prominently, improves the chance of stroke-free survival in high-risk symptomatic patients.

Asymptomatic Carotid Artery Stenosis

Asymptomatic carotid artery disease is highly prevalent in the general population, particularly the patient with evidence of other atherosclerotic disease and in the elderly. Compared with symptomatic stenosis, however, most available data suggest that asymptomatic carotid artery stenosis is associated with a relatively low risk of ipsilateral cerebral infarction. Patients with asymptomatic disease should be considered for surgery when the lesion has reached 70-80%.

Patients can also take action to prevent strokes by:

• Stop smoking
• Controlling high blood pressure
• Lowering cholesterol levels
• Maintaining healthy weight
• Exercising
• Utilizing appropriate medications like aspirin, prescription drugs like anticoagulants
• Treating carotid artery disease
• Treating unruptured cerebral aneurysm or arteriovenous malformation