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Carotid artery disease

Carotid stenosis; Stenosis - carotid; Stroke - carotid artery; TIA - carotid artery

Carotid artery disease causes the carotid arteries to become narrowed or blocked.

The carotid arteries provide part of the main blood supply to your brain. They are located on each side of your neck. You can feel their pulse under your jawline.

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Causes

Carotid artery disease occurs when fatty material called plaque builds up inside the arteries. This buildup of plaque is called hardening of the arteries (atherosclerosis).

The plaque may slowly block or narrow the carotid artery. Or it may cause a clot to form suddenly. A clot that blocks the artery enough to reduce blood flow can lead to stroke.

Risk factors for blockage or narrowing of the arteries include:

Symptoms

At early stages, you may not have any symptoms. After plaque builds up, the first symptoms of carotid artery disease may be a stroke or a transient ischemic attack (TIA). A TIA is temporary reduction in blood flow to the brain that doesn't cause any lasting damage.

Symptoms of stroke and TIA include:

Exams and Tests

Your health care provider will perform a physical exam. Your provider may use a stethoscope to listen to the blood flow in your neck for an unusual sound called a bruit. This sound may be a sign of carotid artery disease.

Your provider also may find clots in the blood vessels of your eye. If you have had a stroke or TIA, a nervous system (neurological) exam will show other problems.

You may also have the following tests:

The following imaging tests may be used to examine the blood vessels in the neck and brain:

Treatment

Treatment options include:

You may have certain procedures to treat a narrowed or blocked carotid artery:

Outlook (Prognosis)

Because there are no symptoms, you may not know you have carotid artery disease until you have a stroke or TIA.

Possible Complications

Major complications of carotid artery disease are:

When to Contact a Medical Professional

Go to the emergency room or call the local emergency number (such as 911) as soon as symptoms occur. The sooner you receive treatment, the better your chance for recovery. With a stroke, every second of delay can cause more brain injury.

Prevention

Here's what you can do to help prevent carotid artery disease and stroke:

Related Information

Carotid artery surgery - open
Stroke
Transient ischemic attack
Recovering after stroke
Cholesterol - drug treatment
Carotid artery surgery - discharge
Taking warfarin (Coumadin)
Angioplasty and stent placement - carotid artery - discharge

References

Biller J, Schneck MJ, Ruland S. Ischemic cerebrovascular disease. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 65.

Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. Stroke. 2021;52(7):e364-e467. PMID: 34024117 pubmed.ncbi.nlm.nih.gov/34024117/.

Nguyen TN, Jovin TG, Nogueira RG, Zaidat OO. Principles of neuroendovascular therapy. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 54.

Xu J, Cao Y. Radiation-induced carotid artery stenosis: a comprehensive review of the literature. Interv Neurol. 2014;2(4):183-192. PMID: 25337087 pubmed.ncbi.nlm.nih.gov/25337087/.

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Review Date: 8/28/2023  

Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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