Stroke is a group of acute cerebrovascular diseases with ischemic or hemorrhagic damage to brain tissue as the main clinical manifestation, and is characterized by high morbidity, disability, mortality and recurrence. Cerebrovascular disease is the third leading cause of human death, with more than 2 million people dying from stroke each year. Cerebrovascular accidents are the leading cause of death and disability in different regions of the world and in different races. Each year, 1.2-1.5 million new complete strokes occur in China, with 800,000-1 million deaths, and about 75% of survivors are disabled, with a recurrence rate of 41% within 5 years. In the United States, 500,000 people develop the disease each year, 150,000 of whom die, and more than 2 million of the survivors require medical care. Cerebrovascular diseases seriously threaten human life and health, and the sequelae such as hemiplegia after stroke not only cause great physical and mental pain to patients, but also bring huge mental and economic burdens to society and families. It is reported that cerebrovascular diseases are generally more prevalent among middle-aged and elderly people over 50 years old, so they are called geriatric diseases. However, in recent years, there is an increasing trend of cerebrovascular disease among young adults under 50 years old, and it is even found among young people in their 30s, especially among young white-collar employees in cities. This may be related to the westernized lifestyle, sitting more and moving less, excessive intake of high-fat and high-calorie foods, as well as high work pressure and excessive stress. Data show that among cerebrovascular accidents, ischemic stroke accounts for 75-90%. The main cause of ischemic stroke is due to narrowing and occlusion of the carotid artery, resulting in ischemia and even necrosis of brain tissue. Since the human brain is very metabolically active, it needs a large amount of blood supply. It is measured that the human brain, which accounts for 2% of the body weight, requires 15%-20% of the blood supply to the whole body. The main channels of blood supply to the brain are the carotid artery system and the vertebral artery system, in which the carotid arteries on both sides supply blood to the brain tissue, accounting for more than 80% of the blood required by the human brain. These arteries are divided into numerous branches within the skull and penetrate into the brain to supply various important structures of brain tissue. Once these vessels are narrowed, occluded or blocked by emboli from other vessels, and there is not enough blood supply from collateral vessels, it can cause ischemia and even necrosis in the brain tissue, resulting in severe neurological dysfunction, such as coma, limb paralysis, speech impairment, sensory impairment, partial blindness, mental retardation, etc. Infarction in certain areas such as brain stem can even cause death. Ischemic stroke is generally divided into transient ischemic attack, reversible ischemic neurological dysfunction, and cerebral infarction. Transient ischemia refers to episodes of neurological dysfunction, such as transient numbness, weakness, and dark haze, which can be recovered within 24 hours. Patients with repeated episodes of transient cerebral ischemia will eventually develop irreversible cerebral infarction. According to statistics, about 1/3 of patients who have transient cerebral ischemia for the first time will develop cerebral infarction within 5 years if they are not given active treatment. The risk of irreversible cerebral infarction in patients with ischemic neurological dysfunction is much greater than that in patients with transient cerebral ischemia; cerebral infarction, on the other hand, is a serious neurological disease in which necrosis occurs in brain tissue due to ischemia, resulting in irreversible permanent neurological dysfunction, such as hemiplegia, hemianesthesia, and aphasia. So far, no method has been found to regenerate brain tissue, and once a cerebral infarction occurs, it is difficult to recover the necrotic brain tissue. Carotid artery stenosis is the main cause of stroke. Ischemic stroke often manifests as sudden onset of numbness, abnormal sensation, upper or lower limb weakness, facial muscle paralysis and sudden loss of vision in one eye. If it occurs in the lateral cerebral hemisphere of the language center, it can cause language impairment. In severe cases, it can cause death or leave severe neurological dysfunction, such as hemiplegia, aphasia, hemianopia, and sensory impairment. Carotid artery stenosis is the main cause of ischemic stroke. The most common cause of carotid artery stenosis is the formation of atherosclerotic plaques, abnormal proliferation of intima and smooth muscle cells in the arterial vascular wall due to abnormal muscle lipid metabolism, which finally leads to narrowing of the lumen diameter of the vessel or even occlusion. When the plaque on the arterial blood vessel wall is dislodged and enters the blood vessels in the brain with the blood flow, it will form emboli and block the cerebral blood vessels. Some small thrombus emboli can dissolve by themselves, blood flow can still be restored, and only cause transient cerebral ischemic attack. However, some large emboli that are not easy to dissolve can cause cerebrovascular infarction, and when repeated attacks occur, they cause multiple lacunar cerebral infarction, resulting in large area of cerebral tissue ischemia. Carotid artery stenosis occurs mostly in middle-aged and elderly people over 50 years old, but in recent years some young people in their 30s have also been found to have carotid artery stenosis. When some symptoms caused by carotid stenosis, such as dizziness, appear in these young people, they are often misdiagnosed and mistakenly treated for cervical spondylosis, resulting in delayed treatment. Doctors remind: once there is transient limb weakness or dizziness, you should immediately go to the hospital, do not blindly treat, especially not as cervical spondylosis and massage at will, resulting in unstable plaque dislodgement leading to cerebral embolism. For those who have high risk factors for occlusive cerebrovascular disease, such as those who are over 40 years old and have hypertension, diabetes, atherosclerosis; those who often have dizziness and discomfort; those who have symptoms of transient cerebral ischemia or a past history of transient cerebral ischemia, carotid artery examination should be done once a year. The main methods are: 1) Carotid ultrasonography, which can measure the diameter and intima-media thickness of the carotid artery, determine the presence or absence of carotid stenosis and the degree of stenosis; check for intima-media plaques and ulcers, and measure blood flow, etc. 2) Magnetic resonance carotid angiography: this method is accurate, intuitive, reliable, painless, and can make a clear diagnosis; 3) Carotid angiography; it is the gold standard for diagnosing carotid stenosis and plaque formation. Magnetic resonance carotid angiography plus ultrasonography can accurately detect more than 95% of patients at high risk of carotid stenosis. The focus of treatment of cerebrovascular diseases should be shifted forward For a long time, the focus of attention on cerebrovascular diseases has been mostly on the treatment after the occurrence of stroke, but carotid endarterectomy shifts the focus of attention forward, that is, on the prevention of stroke before it occurs. The prevention of ischemic stroke is usually treated with medical drugs or surgical treatment, including carotid endarterectomy and endovascular stenting. Commonly used medications include aspirin-based anti-platelet agglutination drugs, vasodilators, anticoagulants, thrombolytic drugs, and Chinese herbal medicines such as Niuhuang Shangqing Wan, Fangfeng Tongxing Wan, Xinhekang, and blood-vitalizing drugs are also effective in preventing ischemic stroke. If it is determined that carotid stenosis exceeds 70% or there are intimal plaques and ulcers, the effect of simple medication is limited, and surgical treatment should be considered to eliminate the “garbage” blocking the blood vessels, so that the blood vessels can be unblocked, the blood supply to the brain can be improved, and the source of emboli can be cut off. If a patient has clinical symptoms such as transient cerebral ischemia, cerebral thrombosis or cerebral infarction, surgical treatment should be considered even if the degree of carotid stenosis is less than 70%. In the 1950s, medical experts successfully performed the first carotid endarterectomy to prevent cerebral infarction. Since then, carotid endarterectomy has become a standard procedure to prevent cerebral infarction, and this procedure is now well established to ensure a safe procedure. The procedure involves exposing the lateral carotid, temporarily clamping the distal and proximal carotid arteries, and then dissecting the carotid artery to remove the “debris” blocking the vessel and restore the carotid artery to its normal size with a smooth inner wall and internal diameter. As the thickened intima and atherosclerotic plaque are removed, the cerebral vessels are unblocked and the blood supply to the brain is improved, while the source of emboli is cut off. Currently, the use of carotid endarterectomy has become a routine treatment for atherosclerotic carotid stenosis in Europe and the United States, with approximately 150,000 people receiving this procedure each year throughout the United States. Two large controlled trials conducted in Europe and the United States in the 1980s showed that carotid endarterectomy reduced the risk of stroke in more than 70% of patients with symptomatic stenosis and more than 60% of men with asymptomatic stenosis. Carotid endarterectomy has a history of more than 50 years. In China, this procedure has not yet been widely performed, and only a few cases have been reported in larger hospitals, but the number is still small. The reasons for this are related to the low level of popularity of medical care in China, the small number of screened patients, and the lack of patient awareness of the dangers of carotid artery stenosis; in addition, the lack of publicity among doctors themselves about the dangers of carotid artery stenosis is also one of the important reasons for the failure to widely perform this procedure in China. Therefore, medical experts call for more popularization of the prevention of cerebrovascular diseases, to clearly inform patients of the dangers of carotid stenosis, to remove the “garbage” in the carotid vessels as soon as possible, and to reduce the risk of cerebral infarction, so as not to lose the best time for treatment by seeking medical attention only after a serious stroke. At the same time, he reminded the readers that cerebrovascular disease is important in prevention, to develop good habits and lifestyle, appropriate control of high cholesterol and high sugar food intake, eat more grains and fresh vegetables and fruits, pay attention to the overall balance of nutrition, life should be regular, learn to relax themselves, car people should walk as much as possible, move more, and actively participate in physical exercise beneficial to the body and mind.