Carotid Disease Flashcards
What can atherosclerosis of the carotids cause?
TIA
Stroke
What is a TIA?
Cerebral ischaemia
Symptoms last LESS than 24 hrs
What is a stroke?
Disturbance of cerebral function due to a vascular event.
Symptoms last OVER 24 hrs or cause death
What are the 2 main causes of stroke?
Cerebral infarction
Haemorrhage
What can cause a cerebral infarction?
Carotid plaque/thrombosis
Carotid artery trauma
Haematological disorder - sickle cell disease
MI
What types of haemorrhages cause strokes?
Primary intracerebral
Subarachnoid
Risk factors?
Male Age Smoking Weight Hyperglycemia Hypertension Hyperlipidaemia Family history Previous DVT to a flight
What examinations are done to diagnose?
Neuro exam with emphasis on contralateral symptoms
Cardiac exam
Auscultating carotids
What are the contralateral symptoms?
Paralysis Paresis Visuospatial neglect Dysphasia Ipsilateral amausrosis fugax - temp blindness in one or both eyes
What is paresis?
Muscular weakness due to nerve damage - partial paralysis
What is dysphasia?
A language disorder causing deficinecy in generation of speech due to brain damage
What investigations can be done?
CT scan
Carotid USS
What is the best medical therapy?
Stop smoking
Control hypertension and diabetes
Antiplatelet meds
Statins
What is a carotid endarterctomy?
Removal of plaque from carotids via incision and then closure
When is a carotid endarterctomy good?
When artery is severely occluded/narrowed
Complications from a carotid endarterctomy?
Wound infection Bleeding Scar VAN damage Stroke
What nerves are near carotids and at most risk?
Glossopharengeal
Hypoglossal
Vagus
How can a carotid endarterctomy cause a stroke?
Cause plaque rupture
Thrombosis
What else could be done besides a carotid endarterctomy?
Stenting
What is the circle of willis?
Basically if one carotid is blocked, perfusion to that side of the brain it supplies (right to left and vice versa) can still happen.
