Carotid stenosis is the narrowing of the carotid artery that supplies the brain with oxygen and nutrients. The disease is caused by deposits in the artery. Carotid stenosis is one of the most common causes of stroke.
What is carotid stenosis?
Smoking and little exercise promote a stroke enormously. See AbbreviationFinder for abbreviations related to Carotid Stenosis.
Carotid stenosis is a narrowing of the carotid artery. Stenosis means “narrowness” and Karotis stands for Arteria carotis. This is the artery that runs on either side of the neck and branches into the internal carotid artery (internal carotid artery) and the external carotid artery (external carotid artery).
The internal artery runs to the brain and supplies it with oxygen and nutrients; the outer one, on the other hand, is responsible for the care of the face. If one speaks of a carotid stenosis, the internal artery is meant. The narrowing is caused by deposits in the vessel, they impede blood flow and thus reduce the blood supply to the brain.
With a carotid stenosis there is always the risk of a stroke, since deposits can loosen, which are then transported to the brain and cause a cerebral infarction there. It is believed that approximately 60% of all strokes are caused by carotid stenosis.
Causes
The cause of carotid stenosis is usually arteriosclerosis (calcification of the vessels). Substances known as arteriosclerotic plaques are deposited in the vessels. They clog the arteries so that the blood can no longer flow freely.
Due to the reduced blood flow, too little oxygen and nutrients are transported, which leads to an undersupply of the corresponding organ. If the carotid artery is affected, this leads to a reduced supply to the brain. Arteriosclerosis, in turn, is usually caused by high blood pressure, unhealthy, high-fat food, little exercise, and smoking.
Most commonly, patients with peripheral arterial disease (PAOD) develop carotid stenosis. In this disease, the vessels in the extremities, i.e. the arms and legs, become calcified. Carotid stenosis also develops in patients with coronary artery disease (CHD), in which the vessels in the heart become calcified, but less frequently in comparison.
Symptoms, Ailments & Signs
Carotid stenosis is often asymptomatic in the first stage. In the later stages, symptoms such as speech disorders, paralysis and nerve disorders appear in the face and limbs. Visual disturbances and dizziness can also occur. In the field of vision, there are disturbances such as blurred vision, double vision or visual field defects, in which the patient no longer has any perception in the left or right part of the visual field.
The visual disturbances last a few seconds to minutes. Speech disorders, hearing problems and swallowing problems can also occur. In the beginning, the symptoms usually only appear for a short time and quickly subside. If left untreated, a stroke can occur. A stroke manifests itself as permanent vision, hearing and speech disorders, paralysis and neurological damage.
Those affected can usually only move to a limited extent and suffer from reduced mental performance. In addition, a slack facial muscles can be noticed. Depending on the severity of the carotid stenosis, cramps, circulatory disorders and other complications can also occur. The carotid stenosis itself occurs quite suddenly and is over in a few minutes. In mild cases only imperceptible deficits remain, in severe cases a stroke can be fatal.
Diagnosis & History
In the early stages, carotid stenosis usually shows no symptoms. Carotid stenosis often goes unnoticed, especially in older people. This is referred to as asymptomatic carotid stenosis or stage I stenosis.
Symptoms only appear in stage II, since the artery is now more narrowed. This can lead to visual disturbances, short-term paralysis, dizziness or speech disorders. In stage II, the symptoms are temporary, which means they resolve again, usually within 24 hours. If it takes more than a day for the symptoms to disappear again, this is referred to as a “little stroke”.
Stage III is carotid stenosis with a newly diagnosed stroke. Stage IV is what doctors call the condition after a stroke with permanent damage. The suspicion of the diagnosis of carotid stenosis initially arises from the failure symptoms. However, in this state the stenosis is already advanced. Deposits in the artery can be made visible by means of ultrasound.
Today, the special duplex ultrasonography is used for diagnostics, with which the severity of the carotid stenosis can also be recognized. Another examination method is angiography, in which, after prior injection of a contrast medium, the arteries are visualized using X-rays or computed tomography (CT) and the carotid stenosis can be detected.
Complications
Carotid stenosis can lead to various consequential damages and complications. In most cases, however, this narrowing leads to a stroke, which in the worst case can also be associated with the death of the patient. For this reason, carotid stenosis should definitely be examined and treated by a doctor.
Those affected can primarily suffer from paralysis, which can occur in different regions of the body. Other sensory or emotional disorders can also limit the patient’s quality of life. Shortness of breath and thus loss of consciousness can also occur. Severe headaches and speech disorders are not uncommon.
Coordination and concentration are also limited and reduced by the carotid stenosis. Patients may continue to suffer from depression and other Saxon upsets or ailments. Carotid stenosis can be treated with surgery and medication.
There are no particular complications. However, life expectancy is reduced in most cases due to carotid stenosis. The person affected must pay attention to a healthy diet and a generally healthy lifestyle.
When should you go to the doctor?
If vision changes, dizziness, speech problems, or other signs of carotid stenosis occur, a doctor should be consulted immediately. If the symptoms occur for more than one day at a time, a doctor must be consulted. Medical advice is also required if the symptoms increase the risk of accidents or have already led to falls in the past. If a stroke occurs, the emergency doctor must be alerted immediately. The patient then requires extensive treatment in the hospital.
Basically, a carotid stenosis must be clarified as soon as possible. If the narrowing is not treated, it can lead to a stroke. Therefore, a doctor should be consulted at the first sign of illness. Older people and stroke patients are particularly susceptible to the development of carotid stenosis and should see a doctor immediately if they experience the symptoms mentioned. Further medical examinations are necessary if the symptoms do not subside or suddenly increase in intensity. Those affected should contact their family doctor or an internist.
Treatment & Therapy
Treatment or therapy for stroke should be initiated as soon as possible. The longer the brain is without oxygen, the more nerve cells die and the brain can no longer be healed. If a stroke occurs, it must be reported to an emergency doctor immediately.
Carotid stenosis is usually treated surgically from stage II. Patients with a narrowing that is as late as stage I are given drugs to stop platelets from forming and to lower blood fats and blood pressure.
Furthermore, statins are administered, which counteract the formation of deposits and thereby slow down the development of arteriosclerosis. Surgical therapy usually consists of a thrombendarterectomy (TEA). With this method, the affected artery is opened lengthwise at the narrowed point and the deposits are peeled out. This procedure can take place under general anesthesia, but also with local anesthesia.
A variant of the TEA is the eversion TEA, in which the calcified part of the artery is separated, freed from limescale deposits using a special procedure and then reinserted. Another possible surgical procedure is carotid angioplasty, in which the constriction is widened by inserting a balloon and a stent (vascular support) is used to keep the artery open. However, this method is not yet routinely used for carotid stenosis; the classic procedure is TEA.
Outlook & Forecast
A narrowing of the carotid artery can be life-threatening. In the worst case, the person affected loses his life in an acute situation. Lifelong physical impairments are also possible, leading to a reduction in quality of life. These are usually irreparable and can lead to psychological complications due to the emotional stress.
If an unhealthy lifestyle is the cause of carotid stenosis, a change in lifestyle must be made as soon as possible. Otherwise, the prognosis is unfavorable, since without medical care it will lead to the death of the person concerned. The diet must be changed and the consumption of harmful substances such as alcohol or nicotine must be avoided completely.
In an advanced stage of the disease, the affected person needs surgery to increase their chances of survival and prevent a stroke. The treatment involves various risks and can lead to complications.
Coping with everyday life must be changed in the case of carotid stenosis. The physical resilience is reduced and leads to a restriction in the performance of usual physical work. This leads to a decrease in well-being and can worsen the overall situation. Those affected by a narrowing of the carotid artery are constantly at risk of an outbreak of an acute health situation. In the event of a sudden deterioration, intensive medical care is required as quickly as possible.
Prevention
Carotid stenosis can be prevented by avoiding the risk factors for atherosclerosis. With a healthy, balanced diet, sufficient exercise, alcohol in moderation and avoiding nicotine, it is possible to effectively prevent carotid stenosis.
Aftercare
Carotid stenosis is a serious condition that definitely needs to be evaluated and treated by a doctor. In most cases, the aftercare measures are relatively limited, so that the person concerned should primarily carry out a quick diagnosis. A doctor should be contacted as soon as the first signs and symptoms of the disease appear, whereby an early diagnosis usually has a very positive effect on the further course of the disease.
The treatment is carried out by taking various medications. The correct dosage must always be observed in order to permanently relieve the symptoms. Likewise, a healthy lifestyle with a healthy diet usually has a very positive effect on the further course of carotid stenosis, so that the person concerned should pay attention to a nutrition plan from a doctor.
If the carotid stenosis is treated by surgery, the person concerned should definitely rest and take care of their body after such an operation. This disease may reduce the life expectancy of the person affected, with the further course depending heavily on the time of diagnosis.
You can do that yourself
The measures to be taken for carotid stenosis depend on the stage of the disease. The first stage does not always require treatment. Patients need to be aware of any symptoms and see a doctor regularly to make sure there are no complications.
Accompanying this, a change in lifestyle can be useful. Depending on the underlying cause of the symptoms, any excess weight must be reduced, stimulants avoided and/or regular sport exercised. With hereditary diseases, the most important measure is to monitor the symptoms. Stage two carotid stenosis is usually treated with surgery. After such an operation, the affected person first needs rest and protection.
Accompanying this, drugs to lower blood pressure and blood lipids are prescribed. In some cases, medication can be supplemented with natural remedies. Painkillers and preparations that dilate the vessels have proven particularly effective. The use of alternative medicines should first be discussed with the doctor. Stage three carotid stenosis requires immediate medical attention. If a stroke has already occurred, first aid must be given until the emergency services arrive.
