There are many reasons for dizziness. The possible cause of short-term dizziness is cerebral ischemia. However, if dizziness occurs suddenly and is accompanied by symptoms such as blurred vision, body numbness, severe headache, etc., it may be a " mini-stroke." " warning signs, of course you need to seek medical attention quickly to diagnose the cause, and " carotid artery stenosis " is one of the important causes of "mini-stroke".
The importance of the carotid artery
The carotid artery is an important source of blood flow from the heart to the brain. After the common carotid artery is divided into the internal and external carotid arteries, the internal carotid artery further branches into the anterior and middle cerebral arteries in the skull, which are responsible for the front of the brain. 2/3 of blood circulation.
Carotid artery stenosis is caused by atherosclerosis, which can cause intracranial arterial embolism
90% of the causes of carotid artery stenosis are the deposition of atherosclerotic plaques that thicken the intima of the blood vessels, thereby blocking the blood vessels or forming thrombi peeling off , is an important cause of stroke caused by cerebral ischemia. According to statistics, up to 80% of strokes are ischemic cerebral infarction, of which about 25-30% are caused by carotid artery stenosis.
Since atherosclerosis is a systemic disease, patients with carotid artery stenosis also face other vascular obstruction problems and risks, including ischemic heart disease , peripheral vascular disease and so on.
Carotid artery hypertension cardiovascular disease myocardial infarction hyperlipidemia
Clinically, carotid artery stenosis is divided into two types: symptomatic and asymptomatic. Symptomatic carotid stenosis refers to the occurrence of ischemic cerebrovascular symptoms in the past six months. The higher the degree of carotid artery stenosis, the greater the risk of ischemic stroke.
Transient cerebral ischemia is actually a warning mild stroke that is a precursor to a serious stroke. Common clinical signs include sudden crooked mouth and eyes, speech impairment, numbness or weakness of one side of the face or body, and temporary weakness in one eye. Amaurosis, etc. These symptoms often return to normal within 24 hours.
However, if larger plaques peel off, causing embolism to larger intracranial arteries, it may lead to acute cerebral infarction, permanent hemiplegia or speech dysfunction.
Cardiovascular hypertension, cardiovascular disease, myocardial infarction, hyperlipidemia
People who have long-term hypertension, diabetes, hyperlipidemia, cardiovascular disease, and family history are all at high risk for carotid artery stenosis, and the incidence rate is higher among men. High, special attention is required.
How to check for carotid artery stenosis?
To examine patients who may have carotid artery stenosis, you can choose to use non-invasive ultrasound for preliminary screening, or use the nearly mature CT or MRI angiography. As for invasive angiography, It can accurately diagnose vascular obstruction, but there are potential risks. For example, during surgery, the thrombus peels off and blocks the distal intracranial blood vessels with the blood flow. About 0.5-1.0% will lead to stroke.
Treatment methods for carotid artery stenosis
For patients with carotid artery stenosis, three treatment methods can be determined depending on the degree of stenosis.
Cardiovascular hypertension Cardiovascular disease Myocardial infarction Hyperlipidemia
1. Drug treatment:
Patients with mild carotid artery stenosis can be treated with drugs, but oral antiplatelet drugs drugs or anticoagulants cannot dissolve the arteries. Intimal sclerotic plaque.
Foreign statistics show that when symptomatic high-grade carotid stenosis is treated with antiplatelet drugs, there is still a 20-25% stroke incidence rate within two years. Current clinical trials have not confirmed the effectiveness of preventing stroke in asymptomatic carotid stenosis, and patients are still A carotid sonogram is required annually.
2. Carotid artery stent placement:
For patients with moderate to severe carotid artery stenosis, angioplasty or stent placement can be performed to unblock the blood vessels and increase blood flow, and also smooth the surface of the hardened plaque deposited in the intima. Prevent thrombosis and peeling. Current foreign clinical literature shows that the therapeutic effect of carotid artery stent placement is no less than that of traditional endarterectomy surgery, and it has lower rates of cranial nerve injury and wound infection.
Cardiovascular hypertension Cardiovascular disease Myocardial infarction Hyperlipidemia
3. Carotid endarterectomy:
For patients with carotid artery stenosis of more than 50% and clinical symptoms, or stenosis of more than 70% and high risk factors, Surgery should be used to remove vascular obstruction. However, patients with abnormal cardiopulmonary function, previous radiation therapy to the neck, too high or too low carotid artery stenosis, and contralateral carotid artery obstruction are at higher risk. After surgery, The incidence of stroke and surgical complications within 5 years is about 5-6%.
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