There are two carotid arteries that supply blood to the brain. The carotid arteries can be felt on each side of the neck, immediately below the angle of the jaw.

There are two smaller arteries called the vertebral arteries that supply blood to the back part of the brain.

The carotid arteries supply blood to the large, front part of the brain, where thinking, speech, personality and sensory and motor functions reside.

What is sarotid artery disease
Carotid artery disease, also called carotid artery stenosis, is the narrowing of the carotid arteries, usually caused by the buildup of fat and cholesterol deposits, called plaque. Like the arteries that supply blood to the heart, the carotid arteries can develop atherosclerosis on the inside of the vessels.

Over time, the buildup of fat and cholesterol narrows the carotid arteries, decreasing blood flow to the brain and increasing the risk of a stroke. A stroke is similar to a heart attack. It occurs when brain cells are deprived of the oxygen and glucose carried to them by blood. Oxygen and glucose are essential for neurons to function and survive. If the lack of blood flow lasts for more than 3 - 6 hours, the damage is usually permanent. A stoke can occur if:

• The artery becomes extremely narrowed
• A piece of plaque breaks off and travels to the smaller arteries of the brain
• A blood clot forms and blocks a narrowed artery

A stroke can occur as a result of other conditions, such as sudden bleeding in the brain, sudden bleeding in the spinal fluid space, atrial fibrillation, cardiomyopathy or blockage of tiny arteries inside the brain.

What are the risk factors for carotid artery disease
The risk factors for carotid artery disease are similar to those for coronary artery disease:

• Family history of atherosclerosis
• Age (men under 75 have a greater risk of developing the disease than women, but the risk is higher in women after age 75)
• Smoking
• Hypertension
• Diabetes
• Obesity
• Lack of exercise

Typically, the carotid arteries become diseased a few years later than the coronary arteries. People who have coronary artery disease have an increased risk of developing carotid artery disease.

What are symptoms of carotid artery disease
There may not be any symptoms of carotid artery disease. However, there are warning signs of an impending stroke. A transient ischemic attack (TIA) is one of the most important warning signs of stroke. TIA occurs when a blood clot briefly blocks an artery that supplies blood to the brain. The symptoms of TIA, which are temporary and may last a few minutes or a few hours, can occur alone or in combination:

• Sudden loss of vision or blurred vision in one or both eyes
• Weakness and/or numbness on one side of the face or in one arm or leg
• Slurred speech, difficulty talking or understanding what others are saying
• Loss of coordination
• Dizziness or confusion
• Difficulty swallowing

TIAs are strong predictors of future strokes; a person who has experiences a TIA is about ten times more likely to suffer a major stroke than someone who has not experiences a TIA.

How is carotid artery disease diagnosed
Carotid artery disease may not have symptoms. It is important for those at risk to have regular physical exams by their doctor. A doctor listens to the arteries in your neck with a stethoscope. An abnormal rushing sound, called a bruit may indicate you have disease. Bruits are not always present when blockages are present and may be heard at times even with minor blockages are present and may be hard at times even with major blockages. It is important to let your doctor know if you have had any symptoms, such as those listed above.

Diagnostic tests include:

• Carotid duplex ultrasound - An imaging procedure that use high-frequency sound waves to view the carotid arteries and to determine the presence of narrowing
• Carotid angiography -  An invasive imaging procedure that involves inserting a catheter into the blood vessel in the arm or leg, and guiding it to the carotid arteries with the aid of a special x-ray machine. Contrast dye is injected through the catheter so that x-ray movies of your carotid arteries are taken. This test may be performed to evaluate or confirm the presence of narrowing or blockage in the carotid arteries, determine the risk for future stroke and evaluate the need for future treatment, such as angioplasty or surgery
• Computerized tomography -  A CT of the brain may be performed if a stroke or a TIA is suspected to have already occurred. This test may reveal areas of damage on the brain.

How is carotid artery disease treated

• Making lifestyle changes
• Taking prescribed medications
• Having procedures as recommended

Lifestyle changes
To prevent carotid artery disease from progressing, lifestyle changes are recommended by our doctor and the National Stroke Association. These include:

• Quit smoking and using tobacco products
• Control high blood pressure, cholesterol, diabetes and heart disease
• Have regular check-ups with your doctor
• Have your doctor check your lipid profile and get treatment, if necessary, to reach a lipid goal of low-density lipoprotein (LDL) less than 100 and high-density lipoprotein (HDL) greater than 45
• Eat foods low in saturated fats, trans fats, cholesterol and sodium
• Achieve and maintain a desirable weight
• Exercise regularly - at least 30 minutes of exercise most days of the week
• Limit the amount of alcohol you drink