A stroke is an injury to the brain. Among the many causes, one of the most common and preventable cause is from plaque in the carotid artery. If the plaque is large enough, it can narrow this artery that carries blood to the brain, disrupting the flow. Small clots can then form and travel up to the brain and cause a stroke.
Plaques are caused by atherosclerosis, sometimes referred to as “hardening of the arteries.” High blood pressure, diabetes, high cholesterol, smoking and being overweight can all contribute to the formation of plaque. Therefore, it’s important to work closely with your doctor to control these conditions.
The most common location for such a plaque is in the middle of the neck where the carotid artery divides into two major branches. Sometimes the turbulent blood flow can be detected just by listening with a stethoscope.
Alternatively, an ultrasound scan will show the artery and measure the blood flow, thereby
determining if a large plaque is present.
If symptoms of a stroke develop, such as sudden weakness of an arm, leg, or one side of the face; difficulty speaking; or loss of vision in one eye, doctors may request a CT scan or an MRI scan to look for plaques, as well as to assess damage to the brain.
Blood thinners are sometimes helpful in reducing the risk of these clots, but unblocking the narrowed artery is the most definitive treatment. For over 50 years, surgeons have been operating through a small incision in the neck to remove the plaque and repair the carotid artery – a procedure called a carotid endarterectomy.
More recently, surgeons have developed techniques to open the artery using balloons and stents. Both procedures are usually successful, but both have a small risk of causing a stroke as well.
Which procedure is safest depends on the individual characteristics of each patient, so it’s important to undergo an evaluation by doctors who are familiar with all techniques and treatments.
Strokes are not always preventable, but if we find a plaque that’s threatening, it deserves to be thoroughly evaluated.