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In the United States, atherosclerosis is a common disease that affects the
arteries, producing a loss of elasticity and a hardening of the arterial wall.
It often is characterized by the formation of hard deposits (plaques) along the
inner wall of the artery, which may cause a blockage. These plaques usually are
made up of fatty tissue, cholesterol and calcium.
Symptoms may occur when these plaques become large enough to narrow your
carotid artery, reducing blood supply to the brain, and acting as a source for
pieces of debris that are washed off the plaque by the flowing blood to lodge in
the eye or the brain. These symptoms may occur alone or in any combination and
include: weakness or numbness of one side of the face, an arm, or a leg;
inability to speak or slurred speech; blindness of one eye (amaurosis); or loss
of consciousness.
Symptoms associated with carotid disease vary in length and may be temporary,
lasting only a few minutes or permanent. If the symptoms clear within 24 hours,
the episode is called a transient ischemic attack or TIA. These symptoms act as
a warning signal, but with corrective surgery or medical treatment, further
symptoms may be controlled before a permanent stroke occurs. It should be noted
that the right side of the brain controls the left side of the body, and the
left side of the brain controls the right side of the body. Thus, symptoms will
be present on the opposite side of the body in relationship to the side of your
diseased carotid artery, except for those involving the eyes. You should be
aware that stenting or surgery will not correct the weakness or blindness already present,
but will help decrease the chance of further stroke or symptoms.
Frequently, carotid disease produces none of the symptoms previously
mentioned. The only indication that you may have carotid disease could be a
"bruit" (a noise in the neck) heard by your physician during a routine
physical examination. Plaques creating such a noise may or may not require
stenting or surgical correction. If stenting or surgery is not indicated, you may be asked to have
follow-up carotid duplex ultrasound examinations to determine whether any
changes in your carotid disease occur with the passage of time. You should also
know the symptoms of carotid disease and you should seek medical attention if
they develop.
Diagnostic procedures
These diagnostic tests may be scheduled on an outpatient basis or upon
admission. Some of the procedures prior to stenting or surgery are as follows:
- Carotid duplex scan -- This is a non-invasive ultrasound study that
provides information about the site and extent of disease. A direct
visualization of the vessel is made using a probe placed on the surface of the
neck.
- Arteriogram -- Arteriograms may be scheduled for you. These X-rays
provide a "road map" of your disease and can be used to plan your
surgical treatment.
- Computerized Tomography (CT Scan) -- In some patients, a CT scan of
the brain may be performed to show if any areas of the brain might already have
been damaged. This is done if there is the possibility of stroke having already
occurred.
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