What Is Carotid Artery Disease?

A fellow caregiver asked...

What is carotid artery disease?

Expert Answer

Jeremy Payne, M.D., is the medical director of Banner Good Samaritan Stroke Center in Phoenix, Arizona.

Carotid artery disease is what happens when the carotid arteries -- a pair of major arteries running up either side of the neck that carry blood to the brain -- fill up with plaque, becoming narrower and restricting blood flow. The condition is called carotid artery occlusive disease, and it often happens with age as a result of atherosclerosis, or hardening of the arteries elsewhere in the body. Other risk factors include smoking, high cholesterol, and diabetes.

Narrowing of the carotid arteries ups the risk of stroke, because strokes are caused by loss of blood flow to the brain. If enough plaque builds up, it can stop blood flow enough to cause a stroke, or a piece of plaque can break off and travel to the brain, where it blocks a blood vessel, causing a stroke. Or the thickening can cause blood to clot, and a clot can cause a stroke. Narrowing of the carotid arteries is responsible for half of all strokes.

People rarely notice symptoms from carotid artery disease by itself. Lots of people have 60 to 70 percent narrowing and have no symptoms. In fact, almost everyone age 75 or older has some asymptomatic narrowing of one or both carotid arteries.

Sometimes doctors can detect the condition by doing a close examination of the neck, looking for swelling as a result of disturbed blow flow. But typically, carotid artery disease is not detected until someone suffers a transient ischemic attack (TIA), also called a ministroke, and notices symptoms from the attack. These include:

  • Sudden numbness, weakness, or even paralysis on one side, such as in a hand, arm, or leg.

  • Sudden onset of speech problems, such as slurred speech, not making sense, or not being able to find the right words.

  • Blurred vision in one eye.

  • Drooping on one side of the face.

If you notice any such signs, you should call 911 or go to the emergency room right away. While you may recover from a TIA and not suffer lasting damage, having a TIA doubles the risk of having a major stroke within the next 24 hours. If you bring these symptoms to a doctor immediately, treatment can prevent the next stroke, which would likely cause lasting damage.