20–25% of all strokes are causally related to a narrowing of the carotid artery (carotid stenosis). Through the turbulence and acceleration of the flow of blood in the area of the blockage, soft plaques, i.e. atherosclerotically altered vascular wall parts, can be torn out and reach the brain. The clogging of the cerebral vessels then leads to limited blood flow with the risk of a stroke that can result in speech disorders, paralysis or even death. Frequently, such blockage is indicated in advance by specific symptoms. Typically, in these symptomatic patients, short-term visual disturbances usually occur in one eye (amaurosis fugax = short-term blindness) or there may be paralysis of the arm, hand or leg, which is also known as a transient ischemic attack (TIA). Symptoms often disappear completely within a short time. They should, however, be taken seriously. To avoid an impending stroke, a quick clarification must be made.
Asymptomatic carotid stenoses are often discovered as part of routine controls. These blockages of the carotid artery would not have been previously noticed because of a transient ischemic attack. Asymptomatic stenoses that show an increase in vascularization over a period of time must be critically assessed. Patients with asymptomatic stenoses should, based on their risk profile, be examined and treated individually depending on how things progress.
The diagnosis of carotid stenosis is primarily arrived at by means of vascular ultrasound. This is in addition to the assessment of blood flow in the head by means of computerized tomography (CT) and/or magnetic resonance angiography (MRA).