Carotid Artery Disease

Carotid artery disease develops when these blood vessels in the front of the neck become blocked or narrow.

These two arteries supply oxygen-rich blood to the part of the brain that controls movement, speech and sensation.

If depleted of oxygen, the cells die, resulting in permanent damage or stroke.

At the University of Maryland Medical Center, our neurosurgery team collaborates with our neurology team and heart and vascular specialists in advancing therapies for stroke and vascular disorders, like carotid artery disease.

Our neurosurgeons develop comprehensive treatment plans using diagnostic, surgical and nonsurgical techniques, then selecting the options that best meet our patients' needs.

Symptoms of Carotid Artery Disease

Most people with carotid artery disease have no symptoms at first. When symptoms do present, they are often in the form of a transient ischemic attack (TIA), or mini-stroke.

During a TIA, a person may experience temporary blindness, weakness in an arm or leg, dizziness, tingling sensations on the surface of the skin or numbness. These mini-strokes rarely last more than 30 minutes, but people who have them are twice as likely to have full-blown strokes.

Causes and Risk Factors

Plaque — made of scar tissue, cholesterol and other fatty substances — builds up inside artery walls. This process of atherosclerosis, also called hardening of the arteries, significantly increases the likelihood of stroke.

The buildup narrows the passages slowing the flow of blood to the brain. Additionally, pieces of plaque and/or blood clots sometimes break away and lodge in the brain's smaller arteries, further restricting the blood flow.

The risk factors are the same as those for coronary artery disease, which is a similar process in the arteries that supply blood to the heart. These factors include smoking, diets high in fat, sedentary lifestyles and a strong family history of heart disease or stroke.

Diagnosis

Doctors often detect the disease during routine physical exams using a stethoscope to listen for murmurs caused by blood rushing through a narrowed part of the neck.

However, doctors cannot always hear these sounds, even when it is severe. Therefore, several other tests can diagnose carotid artery disease. These include ultrasound and CT scans and cerebral arteriograms, which are an X-ray of blood vessels using contrast dye.

Treatment

Lifestyle changes and medications are often the first line of treatment for carotid artery disease. However, when severe, surgery may be necessary. The types of surgeries include:

• Endarterectomy is a less-invasive technique in which the surgeon removes plaque buildup in the arteries by making an incision in the neck.