Carotid Vertebral and Intracranial Artery Stenosis

Your brain arteries are blood vessels that carry oxygen- and nutrient-rich blood from your heart to other parts of your body. When an artery becomes clogged, it can become too narrow to allow blood to flow through to the rest of your body. This narrowing is called stenosis.

Carotid Artery Stenosis

Your carotid arteries are two of the most important blood vessels in your body. Located on the right and left sides of the neck, they carry blood to the neck, face and the center and surface of the brain. If your carotid artery is blocked, you’re at high risk of a stroke. If a stroke happens, blood can’t flow to the brain and brain cells can die.

Vertebral Artery Stenosis

Vertebral artery stenosis (also called vertebrobasilar insufficiency) develops when the vertebral and basilar arteries at the base of the brain become blocked. These arteries carry blood to the brainstem and the cerebellum. Vertebral artery stenosis is a highly dangerous condition because it can prevent oxygen from reaching the brain, causing a stroke or even death.

Intracranial Artery Stenosis

Your carotid, vertebral and basilar arteries are considered extracranial arteries because they’re outside the skull. The arteries inside the skull are called intracranial arteries. When an intracranial artery becomes blocked, it could cause a stroke.

Plaque buildup in the form of fatty deposits and cholesterol sticking to the artery walls can cause carotid artery stenosis, vertebral artery stenosis and intracranial artery stenosis. This buildup causes the arteries to narrow, restricting blood flow to the brain.

A stroke that is triggered by artery stenosis is usually caused by:

• Blood clots
• Insufficient blood flow to the brain
• Total carotid artery blockage of an artery

Risk Factors for Carotid, Vertebral and Intracranial Artery Stenosis

It’s common for some plaque buildup in the arteries to begin around the age of 30, but people between the ages of 40 and 50 are more prone to stenosis than others. Your family history can also be a factor.

The most common risk factors for artery stenosis are lifestyle-related, like:

• High blood pressure
• Lack of exercise
• Obesity
• Smoking
• Stress

Stenosis develops silently over the years. Most people find out that they have a carotid artery blockage when a medical emergency happens. This is why managing your lifestyle risk factors by eating a healthy diet, exercising regularly and avoiding tobacco is so important.

Transient Ischemic Attack (TIA)

The most common way that severe atherosclerosis is discovered is when someone has a transient ischemic attack (TIA). Often called a mini-stroke, a TIA happens when there is a temporary shortage of blood to the brain.

The signs of a TIA are similar to a stroke, but they usually only last a short time. TIA signs include:

• Difficulty speaking
• Dizziness
• Loss of balance
• Numbness on one side of the body

Stroke

When a stroke happens, your brain doesn’t get enough blood and oxygen. Brain cells start to die within seconds.

Knowing the signs of a stroke and knowing when to get immediate medical attention can help save your life or someone else’s. Signs of a stroke include:

• Confusion or disorientation
• Drooping face on one side
• Numbness on one side of the body
• Loss of balance or coordination
• Paralysis on one side of the body
• Slurred speech

If your doctor determines that you’re at risk for carotid, vertebral or intracranial stenosis, several tests can determine if an artery is blocked.

Ultrasound

An ultrasound evaluates blood flow through the body to identify areas of increased pressure in the brain arteries.

MRI and CT Scans

These types of imaging procedures can help determine if you’ve already had a stroke. Some people have multiple TIAs without ever realizing they’ve had a stroke. An MRI or CT scan can identify areas of damaged brain tissue, which could be a sign of a stroke.

Angiography

Angiography uses X-rays to map the flow of blood in the body. Contrast dye is injected into the body to reveal areas of damaged vessels or blocked blood flow. Angiography is one of the most common ways to check for evidence of artery stenosis, stroke, blood clots and TIA.

If you have blocked brain arteries, your doctor may recommend starting with lifestyle modifications and medication to help thin the blood and increase circulation to the brain.

However, if you’ve already experienced a TIA or a stroke, or you have severe stenosis, your doctor will probably recommend more targeted treatments like:

• Angioplasty and stenting: minimally invasive surgery that widens a blocked artery with a small balloon and keeps it open with a stent
• Endarterectomy: a surgery that helps remove buildup inside the artery wall
• Interventional neuroradiology: a minimally invasive procedure that uses X-ray guidance and a tiny catheter to unblock an artery
• Thrombectomy: a minimally invasive procedure that removes blood clots from the veins and arteries, often using a catheter