Carotid Artery Occlusion: Symptoms, Causes, and Urgent Treatment

Carotid artery occlusion blocks blood flow to the brain and is a major stroke risk.

Symptoms

• TIAs (Transient Ischemic Attacks): Temporary weakness, numbness, aphasia, amaurosis fugax (monocular vision loss). Warning signs.
• Stroke: Permanent deficits—hemiparesis, aphasia, neglect, visual field loss.
• Amaurosis Fugax: “Curtain descending” vision loss in one eye (retinal ischemia).
• Neck pain, dysphagia, hoarseness (if mass effect).

Causes

• Atherosclerosis (plaque rupture/thrombosis) – most common.
• Cardioembolism (atrial fibrillation, valve disease).
• Carotid Dissection (trauma, connective tissue disorders).
• Fibromuscular Dysplasia (young women).
• Aneurysm, vasculitis, radiation vasculopathy.

Treatment

• Medical: Antiplatelets (aspirin/clopidogrel), high-intensity statin, BP control, anticoagulation if cardioembolic.
• Revascularization (symptomatic ≥50% or asymptomatic ≥70% stenosis):
  • Carotid endarterectomy (CEA) – open plaque removal.
  • Carotid artery stenting (CAS) – minimally invasive.
• Acute Occlusion: Thrombectomy (if early), thrombolysis (selected cases).

Urgent Action

TIAs require same-day evaluation—stroke risk is highest in the first 48 hours. Call 911 for acute stroke symptoms.