In the northern spring, the weather is hot and cold, and recently we have experienced several rounds of cooling and warming, which can reach more than 10 degrees. This is a time when the temperature is unstable and the incidence of stroke is high. Middle-aged and elderly people with risk factors for stroke should pay special attention to prevent stroke attacks at this time. Among the risk factors for stroke, carotid artery stenosis is an important factor that cannot be ignored. According to clinical statistics, more than 60% of ischemic strokes are caused by carotid artery stenosis, which can lead to disability or even death in severe cases. Therefore, for middle-aged and elderly people, carotid artery stenosis cannot be ignored. Here, I explain in detail how to deal with carotid stenosis and prevent strokes. What is carotid stenosis? To understand this question, we need to first know what the carotid artery is. The carotid artery is the main arterial vessel that exists on both sides of the neck, and is the large vessel that carries blood from the heart to the head and face, and is one of the main blood supply vessels to the brain. For the formation of carotid artery stenosis, it is many middle-aged and elderly people, due to the increase of age, the aging of blood vessels, the deposition of blood lipids, will gradually form atherosclerosis, coupled with some artificial influences such as hypertension, hyperglycemia, hyperlipidemia, smoking, alcoholism and other undesirable factors, will aggravate the atherosclerosis. Over time, blood lipids and impurities are deposited and attached to the walls of the carotid arteries, and the carotid artery intima gradually thickens, forming plaques and even calcification and ulcers, resulting in narrowing of the carotid artery lumen and slowing of blood flow, which is known as carotid artery stenosis. What are the dangers of carotid stenosis? The hazards and symptoms of carotid stenosis are mainly manifested in the following three categories: 1. Most patients with carotid stenosis may have symptoms of cerebral ischemia, such as tinnitus, dizziness, darkness, blurred vision, dizziness, headache, insomnia, memory loss, drowsiness, and excessive dreaming. In case of external carotid artery stenosis, it may lead to eye ischemia, manifested as vision loss, partial blindness, diplopia, etc. 2. Transient ischemic attack, resulting in transient local neurological dysfunction, is generally transient and reversible, and usually recovers within 24 hours after onset, with no aura of onset and no sequelae after recovery. 3. It may cause ischemic stroke, which usually manifests as sensory impairment of one limb, hemiparesis, aphasia, brain nerve damage, and coma in severe cases. In addition, there is another condition in which the carotid plaque is dislodged and enters the brain with the blood flow, blocking the distal arteries and causing acute cerebral infarction, which is very dangerous. Classification of carotid stenosis Carotid stenosis is usually graded in four different degrees according to the severity of the blockage, with stenosis below 50% being mild, stenosis between 50% and 70% being moderate, and stenosis above 70% being severe. This is a very dangerous situation, which may cause acute cerebral infarction at any time, and in serious cases, it may be disabling or even fatal! A typical case of carotid stenosis causing brain infarction Here I describe a typical case of carotid stenosis that I encountered. Mr. An from Yantai, Shandong Province, was attending a dinner party and suddenly fainted. His friends thought he was drunk and sent him home. His family didn’t care much and arranged for Mr. An to sleep. But until the next day, Mr. An still did not wake up. His family took him to the hospital, where he was diagnosed with acute cerebral infarction and severe carotid artery stenosis after examination. It turned out that due to long-term drinking, Mr. An’s cerebrovascular condition was very bad, and he went to seven hospitals in Longkou, Yantai, Guangdong, Fujian and Jinan, all of which were afraid to administer treatment. During this period, he tried other methods of treatment, such as medicine, acupuncture, electrotherapy, massage, Chinese medicine, herbal medicine, prescriptions, etc., almost all the methods used, but still no improvement. Since then, Mr. An has been unable to move his left limb, aphasia, unclear speech, headache and dizziness. In the treatment of carotid stenosis, there are some common misunderstandings: 1, many people believe in the so-called prescriptions, secret recipes, think that the so-called formula can dissolve the plaque, but not timely medical treatment, delaying the disease, so that carotid stenosis gradually aggravated. In fact, these are not credible, once the patient found carotid stenosis should be timely to the regular hospital to receive standardized professional treatment. 2, many people tend to be conservative and backward in concept, afraid of open surgery. Because traditional medicine for thousands of years has been mainly internal medicine, “conservative treatment” has become the only choice for most patients with severe carotid artery stenosis. But in fact, some carotid stenosis is suitable for conservative treatment, while others require surgery, which patients should actively accept. 3. In many local hospitals, carotid artery stenting, which is a relatively simple technique, is widely used, while carotid endarterectomy, which is a more difficult technique, is rarely performed. However, stroke prevention and treatment guidelines clearly state that carotid endarterectomy is the preferred treatment for carotid atherosclerotic stenosis, and stenting is only an alternative option when stripping is not suitable. In dealing with carotid artery stenosis and preventing stroke, the following should be done: 1. People who do not have the disease should actively prevent it. Maintain a reasonable diet, balanced nutrition, moderate exercise, pleasant mood, etc. They should eat more vegetables and fruits, supplement dietary fiber, eat less greasy, spicy and stimulating food, control weight, avoid obesity, strictly control blood pressure, blood sugar and lipid levels, quit smoking and limit alcohol, etc. Not only middle-aged and elderly people, but also young people should actively prevent and control. 2.For patients with mild carotid stenosis (less than 50% stenosis), they should receive professional internal medicine conservative treatment in regular hospitals, mainly including stabilization of atherosclerotic plaque and anti-platelet aggregation drugs. To prevent further aggravation of atherosclerosis and prevent carotid plaque dislodgement resulting in cerebral infarction. In addition, it should include drug control of hypertension, hyperglycemia and hyperlipidemia, and regular review, at least once every six months. 3. For patients with symptomatic moderate to severe carotid stenosis and asymptomatic severe stenosis, those who meet the indications for surgery should actively receive carotid endarterectomy treatment. This is a method that can remove atherosclerotic plaque and reconstruct normal lumen and blood flow, with excellent clinical results. For patients with complete occlusion of the carotid artery, intracranial and extracranial vascular bypass surgery is generally required depending on the situation. For patients with carotid stenosis that cannot be treated with endarterectomy, carotid stenting can be considered. After surgery, patients need to take antiplatelet drugs and plaque stabilizing drugs for a long time.