The left side of the brain runs the right
side of the body; and vice-versa. In right handed people the
left side of the brain (known as the left hemisphere) is
arguably the most important because it supplies the right hand.
This, so-called ‘dominant’ hemisphere also usually controls
speech. In left handed people either the left or the right
hemisphere can be dominant.
If there is a narrowing or blockage of the
left carotid artery then this may result in a lack of blood
supply to the:
Left hemisphere (left front side of the
brain), resulting in loss of sensation and paralysis down the
right side of the body and, in a right handed person, loss
of speech (i.e. a stroke)
Left eye, resulting in blindness
If the blockage lasts for only short period
of time then the symptoms of the stroke may be temporary. This is called a
transient ischaemic attack (TIA). The
word ischaemic is the medical term for lack of blood supply.
Similarly, the blindness can also be temporary; a condition
known as amaurosis fugax.
The recognition of TIA and amaurosis fugax
is important as affected persons are at high risk of going on to
develop a full blown stroke or of going blind if the furring up in
the carotid artery is not treated
All patients found to have furring up of the
carotid arteries should be started on
Best Medical Therapy (BMT)
Smoking cessation: complete and
Control of blood pressure
Anti-platelet agent such as Aspirin
Lipid lowering therapy with a statin
such as Simvastatin 40mg daily at night
BMT will reduce the risks of furring up
getting worse and the risks of stroke and blindness.
If the carotid artery is narrowed by more
than 70% then the risk of stoke and blindness can be further
reduced by by removing the furring up. This is usually done by means of
an operation – called a carotid endarterectomy.
In the future, carotid artery disease may
be treated by carotid stenting where a small metal tube (the
stent) is placed into the artery to keep it open. The advantage
of stenting over surgery is that the stent can be inserted into
the carotid artery via the artery at the top of the leg thus
avoiding any cuts in the neck. At present we do not know if
carotid stenting is as effective as carotid endarterectomy at
preventing strokes and blindness. However, studies are currently
underway and it is possible that in 5-10 years time most
patients with carotid artery disease will be treated by stenting
rather than surgery
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patient information sheet on carotid artery disease and carotid
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