What are the carotid arteries?
The carotid arteries are the main blood vessels that carry blood to the brain. They are located in the neck and are essential for the brain to function.
Carotid stenosis
Carotid stenosis is the narrowing of these arteries, usually caused by atherosclerosis (fatty plaques). It is one of the main causes of ischaemic stroke.
The danger: pieces of the plaque can break off, travel to the brain and block an artery, causing the stroke.
Risk factors
- Age over 60
- Smoking
- High blood pressure
- Diabetes mellitus
- High cholesterol
- Obesity
- Physical inactivity
- Family history of stroke or vascular disease
Symptoms (when they occur)
Carotid stenosis is usually silent until it causes a stroke or a TIA (transient ischaemic attack — a "mini-stroke"). Watch out for:
- Sudden weakness on one side of the body (arm, leg, face)
- Difficulty speaking or understanding
- Sudden loss of vision in one eye
- Dizziness, loss of balance
- Sudden numbness
- Sudden confusion
⚠️ EMERGENCY: If you or someone near you has these symptoms, call emergency services (SAMU 192 in Brazil) IMMEDIATELY.
Diagnosis
- Carotid Doppler ultrasound: the examination of choice — non-invasive and quick
- CT or MR angiography: for surgical planning
- Conventional angiography: the gold standard (rarely used nowadays)
Treatment
Mild to moderate stenosis (< 70%)
- Risk-factor control (stop smoking, blood pressure, diabetes, cholesterol)
- Medication: antiplatelet agent (aspirin), statin
- Regular physical activity
- Doppler follow-up every 6–12 months
Severe stenosis (> 70% symptomatic or > 80% asymptomatic)
- Endarterectomy: surgery to remove the plaque
- Angioplasty with stent: a minimally invasive option for selected cases
Prevention
- Vascular check-up from the age of 50 (or 40 if you have risk factors)
- Stop smoking
- Control blood pressure, diabetes and cholesterol
- Healthy diet and regular exercise
- Carotid Doppler ultrasound as a screening test
Read more about the examination that detects all of this in Doppler ultrasound.