Stroke secondary to carotid stenosis occurs when blood flow to the brain is blocked.�This is usually related to hardening of the arteries (atherosclerosis), particularly those arteries in the neck. Carotid stenosis means hardening of the neck arteries.

Artherosclerosis occurs when�a sticky substance called plaque builds up�in the inner lining of the arteries. The plaque may block or narrow an artery. A blood clot may occur at the site of the plaque.�If a piece of plaque breaks off and travels to an artery in the brain,�it can cause a blockage or even a stroke.�The risks for stroke secondary to carotid stenosis are the same as atherosclerosis.

Stroke secondary to carotid stenosis is most common in older people. Often times, patients with�stroke secondary to carotid stenosis have atherosclerotic heart disease or diabetes.

Radiation therapy to the area may also cause carotid stenosis.

• Weakness or total inability to move a body part
• Numbness, loss of sensation
• Tingling or other abnormal sensations
• Decreased or lost vision (may be partial or temporary)
• Language difficulties (aphasia)
• Inability to recognize or identify sensory stimuli (agnosia)
• Loss of memory
• Loss of coordination
• Swallowing difficulties
• Personality changes
• Mood and emotion changes
• Urinary incontinence (lack of control over bladder)
• Lack of control over the bowels
• Consciousness changes:
  • Sleepiness
  • Stupor, lethargy
  • Coma, unconsciousness

An exam may show:

• Blood clots�in the retina �
• Reflex problems
• Muscle weakness
• Decreased sensation
• A bruit (an abnormal sound heard with the stethoscope) over the carotid arteries of the neck

The following tests may be done:

• Serum lipids blood test (may show high levels of� triglycerides and cholesterol)
• Carotid or cerebral angiography
• Carotid duplex or Doppler ultrasound
• MRI of the head
• MRA (magnetic resonance angiography) of the brain vessels and neck vessels

For specific treatment, see stroke.

Medicine may be prescribed for:

• High blood pressure �
• Cholesterol problem

Surgery to remove the plaque from the carotid (neck) arteries may be needed, especially if�more than 70% of the carotid artery is blocked. The procedure is called�carotid endarterectomy.

Stroke is a leading cause of death in the United States. About 25% of people who have a stroke die from the stroke itself or complications. About half have long-term problems.

However, 25% of people who have a stroke�recover most or all of their function.