Carotid stenosis

Question 1

List three signs/symptoms of carotid stenosis

Answer 1

TIAs, stroke, carotid bruit (amorosis fugax). No screening for carotid disease

Question 2

What are the investigations for carotid stenosis?

Answer 2

Doppler ultrasound
Angiogram
Detection of carotid bruit (present unilaterally)

Question 3

What is the treatment for carotid stenosis?

Answer 3

antiplatelet drugs
BP control, statins
Carotid endarterectomy
Carotid stent

Question 4

What are the indications for carotid endarterectomy?

Answer 4

symptomatic patients and those with moderate stenosis ~>50-79% stenosis. >80% + asymptomatic

Question 5

Which nerve is most likely to be damaged in carotid endarterectomy?

Answer 5

hypoglossal nerve

Question 6

What are the investigations for carotid disease?

Answer 6

CT head and carotid doppler= investigations for presentation of TIA/stroke

Question 7

Patient with amurosis fugax of right eye. Which side will source of the problem arise from?

Answer 7

right retinal artery (not stemming from brain)

Question 8

Left lower limb weakness. Where will the stroke have taken place?

Answer 8

right hemisphere

Question 9

What must you leave in situ after the surgery? (for 24 hours) and why?

Answer 9

drain, to avoid haematoma

Question 10

Name three nerves that can be damages

Answer 10

inferior recurrent laryngeal N, accessory, and hypoglossal