The brain needs the blood supply from the heart to feed the brain cells, and the channel that connects these two most important organs is the carotid artery.
Just as we can often feel our own heartbeat, we can also feel the graceful and powerful rhythm of life when we press our fingers to the side of our neck. This is the result of the blood from the heart, after it is sent out, branching off from the aorta and traveling retrograde along the left and right carotid arteries in the neck and into the brain.
So, what happens if something goes wrong with this bridge of life?
Why does carotid artery stenosis cause dizziness?
As we all know, coronary heart disease is one of the ultimate killers of human beings. The full name of coronary artery disease is “atherosclerotic heart disease”. This term consists of three parts: “heart disease” is understood by everyone; “coronary artery” is a blood vessel located on the heart, which supplies blood to the heart itself muscles; “atherosclerotic” means that the lipids in the blood are deposited on the inner walls of the blood vessels, like millet porridge.
And as time goes by, it gets thicker and thicker like water rust on the inside of a water pipe, eventually making the blood vessels narrower and narrower and blood flow less and less. Even more frightening is the possibility that it will be washed off by the blood flow and various small fragments will enter the blood vessels of the brain, limbs or various 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 brain attack.
This kind of atherosclerosis, occurring in the coronary arteries, is coronary heart disease; and occurring in the carotid arteries, is what we are talking about today carotid artery stenosis.
As the only channel of blood supply to the head, what happens if the carotid artery is narrowed? Brain ischemia, of course. There are various manifestations of ischemia, the most common of which is dizziness and weakness, in addition to memory loss, cognitive decline, and even serious symptoms such as impaired consciousness and numbness of the limbs.
According to statistics, when the narrowing of blood vessels exceeds 70% and the above symptoms occur, the annual probability of cerebral infarction (also known as stroke) is as high as 10% to 15%.
Therefore, when an elderly person in your family has the above symptoms, please make sure to take him to the hospital for a detailed examination!
What tests are needed?
Because carotid artery examinations are not included in the current routine medical checkups, they are usually performed separately in the hospital.
For now, the following tests are common.
Carotid ultrasound, CT, various types of angiography (DSA, CTA, etc.). Among them, carotid ultrasound is relatively inexpensive and does not damage the body, and is often used as a screening tool. Digital subtraction angiography (DSA) angiography, on the other hand, is used as the most important “gold standard” for diagnosis because of its ability to accurately show the condition of blood vessels.
In addition, systemic conditions, such as blood pressure, lipids, and blood sugar, are very important indicators to assist in the diagnosis.
How to prevent it in life?
The phenomenon of atherosclerosis is often closely related to the three highs of hypertension, hyperlipidemia and diabetes. In addition, smoking and alcohol are also important factors that cannot be ignored.
Therefore, for middle-aged and elderly people, the most important thing is to control the three highs from the source, and try to quit smoking and alcohol. On top of that, you also need to control your diet, less oil, salt and spices, more light fruits and vegetables, and at the same time increase exercise to maintain a good figure, which is commonly known as control your mouth and open your legs.
The control of the three highs is very important, in addition to taking medication on time and in the right amount, if you have the conditions, you can buy a portable blood pressure monitor and blood glucose meter at home and monitor it daily.
What is the risk if prevention is poor?
In the European guidelines for the treatment of carotid stenosis, there is a study that the incidence of carotid stenosis is about 1 to 2 percent for the average elderly person over 60 years of age.
When the person has a combination of coronary artery disease, hypertension, smoking and a family history of carotid stenosis, the incidence rises to 67%!
Is surgical treatment needed?
There are two main types of surgical treatment for carotid stenosis, one is carotid endarterectomy (CEA), which involves peeling off the “rice porridge” from the artery wall to restore its original vascular pathway. The other is carotid artery stenting (CAS), which involves putting a stent in to open up the narrowed carotid artery, also with the goal of restoring normal blood flow.
According to the 2011 American College of Vascular Surgeons guidelines for the management of extracranial carotid artery disease, carotid endarterectomy is recommended for asymptomatic patients with > 60% carotid stenosis and symptomatic patients with > 50% stenosis, provided that the risk of surgery is not significant. Carotid stenting is the next best option. Patients with < 50% stenosis are more likely to be treated conservatively with drugs.
However, it is important to note that the treatment guidelines give only a general overview. The disease is very different from one person to another and it is necessary to consult your doctor to develop the most appropriate treatment plan for your individual situation.
Today, society is moving at a rapid pace and diseases are evolving rapidly. Carotid artery stenosis is no longer limited to the elderly, but is increasingly occurring in middle-aged and even young people.
For doctors, a 60% or 70% stenosis may be just a number, but for patients and families, it is often the line between life and death.
What we need to do is to cherish our own lives and the lives of our loved ones, even if it’s just dizziness, please don’t ignore it easily and go to the hospital in time.