Carotid Artery Thrombosis: Symptoms, Causes, Treatment, Surgery, and Management

Definition of Carotid Thrombosis

Carotid thrombosis refers to a condition where a blood clot forms in the carotid artery, blocking or restricting blood flow. Since the carotid artery is the main artery supplying blood to the brain, carotid thrombosis can cause a sharp decrease or interruption of blood flow to the brain, leading to serious cerebrovascular disease. This condition is one of the main causes of stroke, especially ischemic stroke, and is characterized by the formation of a blood clot inside the carotid artery, blocking the artery.

Characteristics of Carotid Thrombosis

Carotid thrombosis primarily occurs when a blood clot formed inside the carotid artery blocks or restricts blood flow. This blood clot may be a mass formed by a complex combination of fat, cholesterol, and calcium accumulated in the carotid intima. The blood clot adheres to the artery wall, gradually restricting or completely blocking blood flow. This condition interferes with blood supply to the brain, leading to a lack of oxygen and nutrients in the brain, and consequently causing a stroke.

The main characteristics of carotid thrombosis are as follows:

• Location of the thrombus: It often forms in the internal carotid artery. Thrombi are more likely to form where blood flow is slow or stagnant.
• Serious consequences: If a blood clot breaks away from the carotid artery, it can block blood flow to the brain, causing an ischemic stroke.
• Onset speed: The size and location of the thrombus can affect the speed and severity of symptom onset.

Causes of Carotid Thrombosis

The main cause of carotid thrombosis is atherosclerosis. Atherosclerosis is a disease in which fatty substances accumulate in the artery walls, causing the arteries to narrow and harden. If atherosclerosis occurs in the carotid artery, a blood clot can form in that area. Other causes that can lead to carotid thrombosis include:

1. Hypertension: Hypertension puts constant pressure on blood vessels, damaging artery walls and increasing the risk of thrombus formation.
2. Hyperlipidemia: High blood cholesterol makes it easier for fatty substances to accumulate in the artery walls, leading to thrombus formation.
3. Smoking: Smoking worsens blood vessel health and is a major factor increasing the risk of thrombus formation.
4. Diabetes: Diabetes damages blood vessels and makes it easier for blood clots to form.
5. Heart disease: Individuals with heart disease or arrhythmias are at a higher risk of blood clot formation.
6. Genetic factors: Individuals with a family history may have a genetic predisposition to blood clot formation.
7. Lack of exercise and obesity: Lack of exercise and obesity can also contribute to thrombus formation.

Symptoms of Carotid Thrombosis

Symptoms of carotid thrombosis vary depending on the size and location of the blood clot. If the blood clot partially blocks the carotid artery, symptoms may be mild. However, if the blood clot completely blocks the artery, serious symptoms can occur. The main symptoms are as follows:

1. Transient Ischemic Attack (TIA): Sudden loss or blurring of vision in one eye. This may be a temporary symptom, often resolving within 24 hours.
2. Paralysis or loss of sensation: Paralysis or loss of sensation in one arm or leg may occur. This is because the blocked blood flow causes a shortage of oxygen and nutrients to the brain.
3. Speech disorder: Difficulty speaking or slurred speech may occur.
4. Dizziness: Insufficient blood supply to the brain can cause dizziness or loss of balance.
5. Headache: A sudden headache may occur.
6. Acute stroke symptoms: If carotid thrombosis progresses severely, stroke symptoms may appear. Stroke symptoms include paralysis on one side of the body, inability to speak, and decreased consciousness.

Diagnosis of Carotid Thrombosis

Carotid thrombosis is diagnosed using various methods. Primarily, non-invasive examination methods are used:

1. Carotid Ultrasound: This is the most commonly used test, allowing for the assessment of the degree of carotid stenosis and the location of thrombus formation.
2. CT Angiography: This method allows for a detailed examination of the carotid and cerebral vessels, enabling accurate assessment of the thrombus location and size.
3. MRI Angiography: Using MRI, the condition of the carotid and cerebral vessels can be assessed more precisely.
4. Blood tests: Blood tests can check for hyperlipidemia, diabetes, and blood clotting status.

Treatment and Surgical Methods for Carotid Thrombosis

Treatment for carotid thrombosis depends on the size, location, and severity of symptoms of the thrombus, and is mainly divided into non-surgical treatment and surgical treatment.

1. Non-surgical treatment

• Medication: If the thrombus develops gradually, medication is the first option. Antiplatelet or anticoagulant drugs can prevent thrombus growth and inhibit the formation of new thrombi. Statins may also be used to treat hyperlipidemia.
• Management of hypertension, diabetes, and hyperlipidemia: Managing hypertension, diabetes, and hyperlipidemia, which are major causes of carotid thrombosis, is crucial. Maintaining blood pressure, blood sugar, and cholesterol levels within normal ranges helps prevention.
• Lifestyle changes: Quitting smoking, maintaining a healthy diet, and regular exercise are essential to improve blood vessel health.

2. Surgical treatment

• Carotid Endarterectomy: This surgery removes the blood clot and fatty substances that have formed in the carotid artery. This surgery is performed when the carotid artery is severely narrowed or the thrombus causes blockage. After the surgery, blood flow is restored, significantly reducing the risk of stroke.
• Carotid Stenting: This method involves inserting a stent into the vessel to widen the carotid artery. It can be chosen for patients who are difficult to operate on or who have high surgical risks. Stent insertion helps to keep blood flow smooth.

Prognosis and Management of Carotid Thrombosis

The prognosis of carotid thrombosis depends on the timing of treatment, as well as the size and location of the thrombus. With early diagnosis and appropriate treatment, the prognosis is quite good. However, if treatment is delayed or inadequate, it can lead to serious consequences such as stroke.

Prognosis

• Appropriate treatment: Restoring blood flow through appropriate medication or surgery greatly helps in stroke prevention.
• Untreated condition: If carotid thrombosis progresses and blood flow is blocked, it can lead to ischemic stroke, resulting in neurological damage.

Management methods

• Regular checkups: Individuals with carotid thrombosis should regularly undergo ultrasound examinations or angiography to monitor the condition of their carotid arteries.
• Lifestyle changes: Maintaining cardiovascular health through a healthy diet and regular exercise is important.
• Medication: It is necessary to consistently manage medications to control blood pressure, blood sugar, and cholesterol.

Conclusion

Carotid thrombosis is a condition in which a blood clot forms in the carotid artery, blocking blood flow, and prompt treatment is crucial. By preventing atherosclerosis, a major cause of blood clot formation, and through appropriate medication and surgical treatment, the worsening of symptoms can be prevented. The prognosis of carotid thrombosis varies depending on the timing and method of treatment, making regular checkups and proactive management necessary.