Carotid artery stenosis and stroke
The carotid artery, the main blood vessel of the brain, works around the clock like a water pipe. If neglected, “rust” and “sludge” will be deposited on the walls of the blood vessels, causing narrowing of the lumen and decreasing blood flow, thus affecting the supply of blood to the brain, which is called carotid stenosis.
What is even more frightening is that these “rust” and “sludge” may be washed off by the blood flow and various small fragments enter the blood vessels of the brain, limbs or organs in the body. Once these fragments block the critical small blood vessels, the lighter the weakness of the hands and feet, the heavier the stroke and cerebral infarction.
Symptoms of carotid artery stenosis
Clinically, carotid stenosis is divided into two categories, symptomatic and asymptomatic, based on whether it produces symptoms of cerebral ischemia.
Symptomatic carotid stenosis
(1) Symptoms of cerebral ischemia: tinnitus, vertigo, darkness, blurred vision, dizziness, headache, insomnia, memory loss, drowsiness, dreaminess, etc. Ocular ischemia manifests as vision loss, partial blindness, diplopia, etc.
(2) TIA: localized transient loss of neurological function, clinically manifested as transient impairment of sensory or motor function of one limb, transient monocular blindness or aphasia, etc., usually lasting only a few minutes, with complete recovery within 24h after onset. There is no focal lesion on imaging.
(3) Ischemic stroke: Common clinical symptoms include sensory impairment of one limb, hemiparesis, aphasia, cerebral nerve damage, and in severe cases, coma, with corresponding neurological signs and imaging features.
Many patients with carotid stenosis do not have any clinical signs and symptoms of the nervous system, which is called asymptomatic carotid stenosis. Sometimes, only a weakened or absent carotid pulsation is detected on physical examination, and a vascular murmur is heard at the root of the neck or at the carotid meridian.
How carotid stenosis is detected
The diagnosis of carotid stenosis is determined by clinical and ancillary tests. Clinical symptoms include symptoms such as cerebral ischemia, TIA, localized transient loss of neurological function, and stroke, as well as some asymptomatic cases.
The most important ancillary tests include carotid ultrasound, CTA, MRA, and DSA digital subtraction angiography. Asymptomatic carotid stenosis, without neurological signs and symptoms, may have positive imaging findings.
How to treat carotid stenosis
There are various treatments for carotid stenosis, including conservative medical treatment, open surgical treatment, and minimally invasive interventional treatment.
1.Conservative treatment: control of high-risk factors, exercise, and medication to stop the progression of carotid stenosis and stabilize and reduce carotid plaque.
2.Open surgery, namely carotid endarterectomy (CEA), is to surgically remove carotid plaque and restore lumen patency by directly removing the stenosis.
3. Interventional methods such as carotid stenting (CAS) is the use of carotid stenting to remodel the carotid plaque, attach it to the wall, and thereby relieve the stenosis.
How to prevent carotid artery stenosis
Life guidance
1. Stop smoking and limit alcohol consumption.
2, reasonable exercise, depending on the individual (can choose walking, brisk walking, jogging, swimming, etc.).
3, control blood lipids, blood sugar, blood pressure and other high-risk factors.
4, quit “pride” and “dryness”, control your emotions.
Dietary guidance
1.Advocate a “cereal-based” dietary structure.
2.Ensure sufficient dietary fiber (such as celery, cabbage, fungus, etc.).
3, increase the supply of vitamins and minerals, and drink more water.
4.Reduce the intake of high-fat food (such as animal fat, fried food, etc.).
Medication guidance
Take relevant drugs (e.g. antiplatelet, inhibition of intimal hyperplasia, statins) strictly according to the doctor’s instruction, mainly through the drug’s anticoagulation, expulsion of aggregation, stabilization of plaque function and inhibition of intimal hyperplasia, so that the risk of stroke due to carotid stenosis is reduced.
Protect your carotid arteries and say no to stroke. Professor Qu Le Feng recommends that elderly people over 60 years old, especially those with smoking habits, those with hypertension, diabetes, hyperlipidemia or coronary heart disease, lower limb atherosclerosis occlusive disease and those with a family history of stroke, should have their carotid arteries checked regularly for early detection of atherosclerotic plaques and early treatment to nip the disease in the bud, improve the quality of life and prevent stroke.