The greatest risk of carotid plaque leads to stroke, so the management needs to be determined by the nature and size of the plaque. Generally speaking, most of the plaques in carotid arteries are related to age and atherosclerosis, along with some risk factors. For example, hypertension, diabetes, coronary heart disease, hyperlipidemia, obesity and other risk factors are related to systemic atherosclerosis. Carotid plaque is found on physical examination, which is a manifestation of atherosclerosis. It depends on the size of the plaque, its softness and the presence or absence of plaque rupture. Small plaques, those that do not cause carotid stenosis and non-floating plaques can be temporarily treated without surgery and should be followed and observed, but antiplatelet drugs must be applied to prevent microthrombosis. If the plaque is found to increase in size and cause carotid stenosis, surgery should be performed promptly. What are the symptoms of carotid artery stenosis? Transient dizziness, blackness in front of the eyes, or even transient motor impairment of speech or one limb, also known clinically as transient cerebral ischemic attack, is often caused by problems in the carotid system, such as intracranial vascular stenosis, spasm or carotid stenosis, and microthrombus dislodgement from blood vortex. Therefore, when patients experience transient dizziness and blackness in front of the eyes, they should go to the hospital for a carotid color Doppler ultrasound examination. If the ultrasound reveals stenosis, further CTA and TCD examinations should be performed to clarify the extent and degree of stenosis and the condition of intracranial arteries. The relationship between the degree of carotid stenosis and surgical treatment Carotid artery stenosis found on examination should be treated accordingly depending on the degree of stenosis. If the stenosis is less than 50%, the clinical condition is asymptomatic and can be treated with anti-platelet drugs, so surgery is not necessary. What are the surgical treatment options? The current surgical method for carotid stenosis is carotid endarterectomy, which is a surgical procedure to remove plaque and thrombus from the carotid artery. Carotid artery stenting is a new treatment technique developed in recent years, in which a metal stent is implanted into the narrowed carotid artery through the femoral artery to support the narrowed area and to facilitate blood flow. It is a minimally invasive interventional treatment method with no incision in the neck and can be discharged in 1 to 2 days after surgery, which is more suitable for elderly patients and patients with higher surgical risks. In general, cervical spondylosis can also lead to inadequate blood supply to the head, but mostly the vertebral artery is compressed and less often the carotid artery is affected. The information you provided clearly suggests insufficient blood supply to the carotid artery, so we recommend that you have another definitive examination, such as MRA or angiography of the carotid artery.