Skip to Main Content

++

  • Carotid stenosis

++

  • 433.1 Occlusion and stenosis of carotid artery

++

  • I65.29 Occlusion and stenosis of unspecified carotid artery

++
++

Description

++

  • Carotid arteries become blocked or receive limited blood flow
  • Carotid stenosis: narrowing of the artery
  • Plaque builds up in the artery
  • Plaque can be stable and asymptomatic
  • Clots can lead to a stroke
  • Can result in a sudden, specific neurological deficit

++

Essentials of Diagnosis

++

  • Stethoscope on carotid artery, bruit sound
  • Lipid profile
  • Triglycerides test
  • CVA symptoms

++

General Considerations

++

  • Ischemic (2 types)
    • Thrombotic: Atherosclerotic plaques and hypertension (HTN) produce CVA due to plaques that form at the branching and curves of arteries
    • Embolic: An embolus that causes a CVA can travel from the heart, internal carotid artery thrombosis, or atheromatous plaque of the carotid sinus
      • Branches of the middle cerebral artery (MCA) are most commonly affected

++

Demographics

++

  • About 4 million Americans suffer physical impairments and disability from stroke
  • 2/3 of all CVAs occur in individuals older than 65 years of age
    • After age 55, risk of stroke doubles every 10 years
  • Incidence is greater in men than in women and twice as high in blacks as in whites
  • Cerebral infarction (thrombosis or embolism) is the most common form, accounting for 70% of all strokes, followed by hemorrhages at 20%, and 10% unspecified

++

Signs and Symptoms

++

  • Patients may not have any narrowing or blockage of arteries
  • Palpable pulse under the jaw line
  • Headaches
  • Blurred vision
  • Memory loss
  • Signs and symptoms are dependent on the part(s) of the brain affected by the CVA as well as the amount of damage to the tissues from obstruction or hemorrhage
  • Weakness in a region, motor planning deficits
  • Symptoms of cerebrovascular accident (CVA) include
    • Sensory loss/dysfunction
    • Aphasia
    • Dysarthria
    • Communication difficulties/Dysphagia
    • Visual field defects
    • Cognitive impairment
    • Hemiplegia (most commonly) Motor loss
    • Autonomic dysfunction
    • Perceptual changes
    • Personality, and behavioral changes
    • Changes in consciousness
    • Spasticity or hypertonicity

++

Functional Implications

++

  • CVA
    • Loss of independence with all aspects of mobility, ADLs, self-care
    • Loss of ability to interact with others effectively
    • Difficulty with cognitive processing, particularly executive function

++

Possible Contributing Causes

++

  • HTN
  • Arteriovenous malformation (AVM)
  • Hyperlipidemia
  • Cardiovascular disease, coronary artery disease, atrial fibrillation
  • Obesity
  • Alcohol abuse
  • Smoking
  • Sedentary lifestyle
  • Pulmonary insufficiency
  • Peripheral vascular disease
  • Diabetes
  • Family history of stroke or transient ischemic attack
  • Patent foramen ovale
  • Marfan syndrome
  • Fibromuscular dysplasia

++

Differential Diagnosis

++
++

Laboratory Tests

++

  • Vital signs
  • Stethoscope on carotid artery, bruit sound
  • Neurovascular tests: neck flexion for meningeal irritation, ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.