By Tommy L. Fudge, M.D.
Medical Director,
Cardiocascular Institute of the South /Surgery

When part of the brain is deprived of oxygen, it ceases to function -- with potentially catastrophic effects. If the resulting impairment is permanent, we call the event a stroke. If it is temporary, it's called a transient ischemic attack (TIA). In either case, assessment and treatment by a cardiovascular specialist is imperative.

TIAs and strokes generally originate with a buildup of cholesterol plaque in the carotid arteries -- the large blood vessels on either side of the neck which supply blood to the head and brain.

These buildups evolve over many years, and rarely produce any symptoms until crumbly portions of the plaque break away and are carried to smaller arteries, where they block the flow of blood. Whether the result is a stroke or a TIA depends on how large an area of the brain is affected and how complete the blockage is.

In either case, the symptoms can include loss of strength in an arm or leg or in the muscles of the face, temporary visual loss, slurred speech, dizziness, seizures or unconsciousness.

Carotid artery disease can occur at any age, but is more common in people over 45. Those at high risk include smokers, people with high blood pressure or high levels of blood cholesterol, diabetics and those with a family history of arterial disease.

Initial testing for carotid artery disease is a painless ultrasound procedure in which a microphone-like device is applied to the neck.

If a possible blockage is detected, the next step is an angiogram, in which x-ray opaque dye is injected into the artery to determine the location and extent of the constriction.

Even with blockages which reduce blood flow as much as 80 percent, the most likely form of treatment is medication and regular checkups. For more severe blockages, surgical removal of the plaque is required. The operation, called an endarterectomy, takes only about an hour. The patient usually goes home in two or three days, and resumes normal activities within weeks.

If you experience the symptoms of a TIA, however slight, see your doctor at once. It is the best warning your body will give you that you are in danger of a stroke.

&copy 1995 Cardiocascular Institute of the South

For further information, call Jane Arnette, Cardiocascular Institute of the South/Houma, 1-800-425-2565, or Jim Keyser at 1-800-848-2715. E-mail questions or comments to: jakeyser@cardio.com.

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