Cerebral blood flow pathway to prevent cerebral infarction and dementia… Protect the 3cm “double Y” left and right of the neck [건강한 가족]

Carotid artery stenosis warning

Every organ in the body receives oxygen and nutrients through blood vessels. Sudden death occurs when blood vessels to the heart become blocked, and fatal sequelae remain when blood vessels to the brain become blocked. The current blood vessel of interest is the carotid artery. It is an artery that passes through the neck and is located 3 cm to the left and right of the neck. It is an important blood vessel through which 80% of the blood from the heart to the brain passes. However, the carotid artery is one of the blood vessels prone to atherosclerosis. As dietary habits become Westernized and we enter an aging society, the number of patients suffering from stenosis, in which the carotid artery narrows and hardens, has increased significantly. Last year, more than 110,000 people were treated for carotid artery stenosis.

Carotid artery stenosis is scary because it is directly related to brain health. When fat builds up in the carotid artery blood vessels and muscle cells proliferate, blood flow to the brain becomes insufficient, which can lead to a cerebral infarction. In addition, unstable blood clots accumulated in the carotid artery fall out and block blood vessels in the brain, causing cerebral infarction to progress. Professor Woo Ho-geol from the Department of Neurology at Kyung Hee University Hospital said: ‘Carotid artery stenosis is not only a problem of narrowing of blood vessels, it can also cause a stroke by blocking blood vessels in the brain if a blood clot breaks off.” Moderate stenosis with more than 50% narrowing of the carotid artery in the population 65 years of age and older is estimated to be 5-10%, and severe stenosis with more than 80% causing many changes in blood flow is estimated at about 1%.

In particular, due to the thickening and narrowing of the blood vessel walls, the decrease in blood flow becomes chronic, which can lead to dementia. According to an article published in the international academic journal “Stroke” in 2015, the risk of developing mild cognitive impairment and dementia increased by 25% 5 years after carotid artery wall thickness increased by 0.1 mm. The problem is that in the case of the carotid artery, even if half of the blood vessels are blocked, there are no particular subjective symptoms. If you have a family history of cerebral infarction, diabetes, hypertension, dyslipidemia, or vascular disease in the heart or extremities, carotid artery ultrasound is recommended to be performed regularly from the age of 40 to 50. Professor Woo said: ‘If you experience sudden darkness before your eyes, a sudden loss of strength in your limbs, or symptoms of dizziness or facial paralysis, get an ultrasound without delay.’

The main goal of treatment for carotid artery stenosis is to prevent cerebral infarction. Because the risk of cerebral infarction varies with the degree of stenosis and whether symptoms occur, the risk of stroke is first determined through ultrasound. In case of cerebral infarction or transient cerebral ischemia due to carotid artery stenosis within 6 months, active treatment is recommended. Typical examples include carotid endarterectomy, in which the carotid artery is incised and fatty tissue blocking the blood vessel is removed and then sutured, and stenting, which widens the blood vessel by inserting a stent into the blood vessel.

These days, there are quite a few cases of accidental discovery during health checkups. It is debatable whether surgery or treatment is needed for asymptomatic strictures. Experts prioritize risk factor control when there are no symptoms and the degree of carotid artery stenosis is less than 50%. The incidence of cerebral infarction in asymptomatic stenosis is 0.3%. If you are a smoker, it is okay to stop smoking, have your blood pressure, blood sugar and cholesterol levels checked, and administer medication if necessary. Also, regular follow-up checkups are done to make sure the severity of the stricture isn’t getting worse. However, even in asymptomatic patients, if the degree of stenosis is greater than 70%, surgery or treatment with consideration of age or other vascular conditions may be considered.

The status of atherosclerotic plaques (plaques) also serves as an indicator of high risk. If many microembolic signals are observed on cerebral blood flow ultrasound, the small clots fall and ascend to the cerebral vessels, suggesting that the clots accumulated in the carotid artery are in an unstable state and appropriate treatment should be followed. One study showed that 15.6% of patients with a large number of microembolic signals had a cerebral infarction within one year.

Also, if blood vessels narrow, if the atherosclerotic plaque is bumpy or the surface is hollowed out like an ulcer, if the inside of the atherosclerotic plaque is accompanied by bleeding, or if the fat is large, a thrombus can block the artery. carotid artery or detach and block the cerebral blood vessel. I think the risk is high. Professor Woo stressed: ‘Because restenosis can also occur after surgery or a procedure, it is more important than anything else to continuously manage risk factors.’

The key to managing risk factors is controlling hypertension, diabetes and dyslipidemia. For the purpose of treatment, it is necessary to maintain a healthy diet and exercise. A Mediterranean diet consisting of fresh fruits and vegetables, low-fat dairy products, fish and vegetable fats is recommended. For exercise, it is better to walk briskly or jog slowly for 30 minutes a day, 3 times a week or more rather than strenuous events. I’m out of breath and sweating, but it’s okay to be able to have a conversation with the person next to me.

Sunyeong Kim ([email protected])