Carotid artery disease Flashcards
Carotid dissection
- Epidemiology (age, morbidity/ mortality)
- Causes
- Risk factors
Rare disease, mean age=45
- Morbidity= 30%
- Mortality= 23%
Causes
- Spontaneous
- Iatrogenic
- Traumatic
Risk factors
- HTN
- Marfan’s
- OCP
- FMD (Fibromuscular dysplasia, abnormal growth in blood vessel wall)
Carotid dissection
- Presentation
Symptoms
- Headache
- Neck pain
- Syncope
Signs
- Horner’s syndrome
- Bruits
- CN lesions
- TIA/ CVA
Carotid dissection
- Investigations
Imaging
- Duplex USS
- CT/ MRI
Carotid dissection
- Treatment
Anticoagulation (3-6months)
Carotid aneurysm
- Causes
Infection
- TB
- Syphilis
Atherosclerosis
Trauma
Post- CEA
Marfan’s
Fibromusclar dysplasia
Cystic medial necrosis
Carotid aneurysm
- Presentation
Symptoms
- Neck pain
Dysphagia
Signs
- CN lesion
- Neck lump
- TIA
Carotid aneurysm
- Investigations
Imaging
- Duplex USS
- Angiogram
- CT/ MRI
Carotid aneurysm
- Management
Anticoagulation= Aspirin ONLY
Ligation
Resection + repair
Carotid body tumour
- Epidemiology
10% malignant
8% bilateral
Familial
- Increases incidence malignancy + bilateral.
Carotid body tumour
- Investigation
Imaging
- Duplex USS
- CT scan
- MRI
- Angiogram
Carotid body tumour
- Treatment
Srugical resection
- With or withour ICA replacement
Carotid occlusive disease
- Definition
- Complication
Atheroma at carotid bifurcation
Emboli from plaque
- Into middle cerebral artery/ opthalmic artery
Carotid occlusive disease
- Medical Management
Medical= control risk factors
- Cholesterol control
- Smoking cessation
- BP lowering
- Glucose control for DM
Preventing clots
- Antiplatelet drugs(aspirin, clopidogrel)
- LMWH, warfarin
Stroke
- Epidemiology (incidence, prevalence 5 year survival)
Incidence
- 90-300/ 100K
Prevalence
- 500-600/ 100K
30 day mortality
- 8-20%
5 year survival
- 64% F
- 56% M
Carotid occlusive disease
- Pathophysiology
Atheroma in CCA or ICA travels into MCA/
