Carotid Artery-Related Infarction: Types, Causes, Symptoms, Treatment, Surgery, Mortality, and Pain

Carotid Artery-Related Infarction

Carotid artery-related infarction is a condition in which insufficient blood supply to the brain, or temporary blockage of blood supply, due to abnormalities in the carotid artery's blood flow, leads to a lack of oxygen and nutrients in the brain, causing damage to brain cells. The carotid artery is one of the major blood vessels supplying blood to the brain, and abnormalities in the carotid artery can have serious effects on the brain. Carotid artery-related infarction is generally a form of stroke, closely related to cerebral infarction.

1. Definition

Cerebral Infarction due to Carotid Artery Disease is a disease in which reduced blood flow due to narrowing or blockage of the carotid artery causes insufficient blood supply to the brain, leading to damage to the brain tissue in that area due to lack of oxygen and nutrients, resulting in infarction. The main causes are the development of atherosclerosis in the carotid artery or the formation of a thrombus in the carotid artery, leading to narrowing or blockage of the blood vessel. Carotid artery-related infarction usually occurs as acute cerebral infarction, resulting in the loss of function in a part of the brain.

2. Characteristics

The main characteristics of carotid artery-related infarction are as follows:

1. Cerebral infarction due to insufficient blood flow:

• When blood supply to the brain through the carotid artery is insufficient or absent, blood does not reach the affected brain area, causing brain cells to die or be damaged, resulting in infarction.

2. Stenosis or occlusion of the carotid artery:

• The main cause of carotid artery-related infarction is stenosis or occlusion of the carotid artery. This is caused by atherosclerosis, where plaque builds up on the arterial wall, narrowing the blood vessel, or by the formation of a thrombus, blocking the blood vessel.

3. Occurrence of acute symptoms:

• Abnormalities in blood flow due to the carotid artery can occur suddenly, and patients may experience neurological symptoms suddenly. Acute symptoms that occur when cerebral blood flow is blocked are mainly observed.

4. Main risk factors:

• Hypertension, hyperlipidemia, diabetes, smoking, and older age are major risk factors for carotid artery-related infarction. These risk factors promote atherosclerosis and thrombus formation in the carotid artery, leading to infarction.

3. Causes

The main causes of carotid artery-related infarction are as follows:

1. Atherosclerosis:

• Atherosclerosis is the accumulation of cholesterol, fat, and calcium in the carotid artery, forming plaque. This plaque thickens the inner lining of the blood vessel, narrowing it. The narrowed vessel obstructs blood flow, and thrombus formation can lead to vessel blockage and infarction.

2. Thrombus formation:

• If a thrombus forms in the carotid artery, the blood vessel is occluded, and blood flow is blocked. Thrombi usually form when plaque associated with atherosclerosis ruptures and blood clotting occurs.

3. Hypertension:

• Hypertension exerts constant pressure on blood vessels, damaging the blood vessel walls and promoting atherosclerosis. Hypertension can cause blood flow disturbances in major arteries, including the carotid artery.

4. Hyperlipidemia:

• Hyperlipidemia is the accumulation of excessive cholesterol and fat in the blood, which can worsen carotid atherosclerosis and increase thrombus formation.

5. Diabetes:

• Diabetes is a condition in which blood sugar is difficult to control, damaging blood vessels and worsening atherosclerosis. Also, high blood sugar increases blood viscosity, making it easier for thrombi to form.

6. Smoking:

• Smoking constricts blood vessels and promotes blood clotting, increasing the risk of thrombus formation. Smoking is also a significant factor in accelerating atherosclerosis.

7. Genetic factors:

• If there is a family history of atherosclerosis, hypertension, or hyperlipidemia, the risk of carotid artery-related infarction may increase.

4. Symptoms

Symptoms of carotid artery-related infarction occur acutely and are usually associated with a sudden decrease in cerebral blood flow. The main symptoms are as follows:

1. Paralysis:

• When carotid blood flow is blocked, parts of the brain suffer from lack of oxygen, causing paralysis in one side of the arm, leg, or face. Symptoms similar to stroke are particularly noticeable.

2. Speech disorder:

• When cerebral blood flow is blocked, the brain area responsible for speech is affected, leading to speech disorders. This can result in difficulty speaking or impaired comprehension.

3. Visual impairment:

• Due to insufficient blood flow to the brain, visual problems may occur. Usually, loss of vision in one eye or blurred vision may appear.

4. Dizziness and loss of balance:

• When cerebral blood flow is blocked, patients may experience dizziness or difficulty maintaining balance. This is because the part of the brain responsible for balance is affected.

5. Headache:

• Headaches can occur due to impaired cerebral blood flow caused by the carotid artery, and these headaches are often sudden and severe.

6. Other neurological symptoms:

• Vomiting, confusion, decreased concentration, and memory loss may accompany these symptoms, which are caused by the effects on various areas of the brain.

5. Treatment and Surgical Methods

Treatment for carotid artery-related infarction must be prompt and effective, and it is important to restore blood flow and minimize brain damage. Treatment methods include medication and surgery.

Medication

1. Anticoagulants (blood clot prevention):

• If there is a thrombus in the carotid artery, anticoagulants are used to prevent the thrombus from growing or new thrombi from forming. For example, drugs such as aspirin or warfarin can be used.

2. Thrombolytics:

• Thrombolytics are used to quickly dissolve the thrombus blocking the blood vessel, attempting acute treatment. The most representative drug is **rt-PA (recombinant tissue plasminogen activator)**.

3. Statins:

• Statins lower cholesterol levels, helping prevent atherosclerosis and improve carotid stenosis.

Surgical Treatment

1. Carotid Endarterectomy:

• This surgery removes plaque or thrombi formed in the carotid artery and is performed when cerebral blood flow is insufficient due to carotid stenosis or occlusion. This surgery removes the inner lining of the carotid artery to improve blood flow.

2. Carotid Artery Stenting:

• If endarterectomy is difficult, a stent is inserted to dilate the carotid artery and improve blood flow. This is a less invasive method and is used for high-risk patients.

6. Prognosis and Management Methods

The prognosis of carotid artery-related infarction varies depending on the timing and method of treatment. If treatment is started early, the possibility of recovery is high, but if treatment is delayed, brain damage can occur, and long-term sequelae may remain.

Prognosis

• Early treatment: Early diagnosis and treatment of carotid artery-related infarction can reduce the degree of brain damage and promote functional recovery. The prognosis can be good, especially if medication and surgery are appropriately performed.
• Delayed treatment: If treatment is delayed, brain damage can become severe, and paralysis, speech disorders, and visual impairments may persist in the long term.

Management Methods

1. Healthy lifestyle habits:

• Prevention and management of carotid artery-related infarction require a healthy diet, regular exercise, smoking cessation, and moderate alcohol consumption.

2. Regular checkups:

• High-risk groups (hypertension, hyperlipidemia, diabetes, etc.) should have regular blood pressure, blood sugar, and cholesterol tests to check the condition of the carotid artery and receive appropriate treatment.

3. Medication management:

• Medication to control risk factors such as hypertension, hyperlipidemia, and diabetes is essential. Continuous use of anticoagulants or antiplatelet agents may be necessary.

4. Stress management:

• Psychological stress raises blood pressure and negatively impacts cardiovascular health, so it's important to manage stress.

Conclusion

Carotid artery-related infarction is a cerebral infarction that occurs when blood flow to the brain is blocked due to stenosis or occlusion of the carotid artery. This condition can be promoted by various risk factors, including hypertension, hyperlipidemia, diabetes, and smoking, and symptoms appear suddenly. Treatment for carotid artery-related infarction involves medication and surgery; early diagnosis and prompt treatment are crucial, and regular checkups and management are necessary.