Skip to Main Content

Condition/Disorder Synonym

  • Carotid stenosis

ICD-9-CM Code

  • 433.1 Occlusion and stenosis of carotid artery

ICD-10-CM Code

  • I65.29 Occlusion and stenosis of unspecified carotid artery

Preferred Practice Pattern

Key Features


  • 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


  • 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

Clinical Findings

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


Pop-up div Successfully Displayed

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