Symptoms (visible effects of a disease) indicate the occurrence of brain damage caused by atheromatous plaque in the carotid artery.
A – There are three main symptoms :
1) Hemiplegia is the paralysis of the hemicorpus (one half of the patient's body, upper and lower limbs) on the opposite side of the carotid stenosis (the left side of the brain controls the right hemicorpus. The right side of the brain controls the left hemicorpus).
Such a paralysis may be only partial. It may show only through clumsiness of the hand or some trouble in walking.
It may be total, with a paralysis of the entire upper and lower limbs.
It may be associated with a facial paralysis (paralysis of one half of the face).
2) Aphasia and dysarthria are difficulties in speaking. They may cause language to become totally incomprehensible.
3) Monocular blindness is a vision disorder in a single eye, homolateral to (on the same side as) the arterial carotid stenosis. It usually appears as a gray or black veil slowly descending in front of the eye. When a vision disorder appears, it is appropriate to successively block each eye with the hand in order to detect whether both eyes or only one eye is affected. Should only one eye be affected, it is useful to note whether it is the right eye or the left as this information is very important to your physician.
B – These neurological symptoms are classified according to their duration into the following categories :
1) Transient ischemic disorder
By definition, such a disorder lasts for less than 24 hours. In effect, most transient ischemic disorders last only from a few seconds to a few minutes: clumsiness of the hand that impairs writing during a very short time or causes the victim to drop an object, a gray veil that descends in front of one eye and disappears almost immediately with the return of perfectly clear vision, difficulty in speaking that interrupts a conversation for a short time.
Despite their short duration, these transient ischemic disorders must be taken very seriously and should be checked as soon as possible by a physician or at an emergency clinic (which will conduct additional and indispensable tests), because they may be precursors of a much more serious neurological incident.
2) Regressive cerebral ischemic disease
In this scenario, symptoms last for longer than 24 hours but less than three weeks. They leave no visible sequelae but often correspond to the destruction of a small portion of the brain.
3) Minor established cerebral ischemic disease
In this scenario, symptoms regress almost completely in over 3 weeks. Sequelae are moderate and disturb the patient very little in his everyday life (small constraint while writing or walking, slight difficulty in speaking, limited vision disorder in one eye).
4) Major established cerebral ischemic disease
In this scenario, sequelae are still significant beyond the first three weeks following the onset of the disorder. They may be permanent and constrain the patient considerably during his everyday life, even rendering him/her unable to move without help or to speak. This form of the disease may lead to death.
Only narrow stenoses (voluminous atheromatous plaque) carry a high risk of causing a cerebral ischemic incident.
These symptoms may be the result of a disease other than arterial carotid stenosis: cardiac disease, disease of the small cerebral arteries, atheromatous plaque in the arch of the aorta, stenosis of the supra-aortic trunks, stenosis of the sub-bulbar internal carotid artery, stenosis of the carotid siphon, etc.
When facing any neurological symptoms, it is appropriate to consult a physician or an emergency clinic as soon as possible.
Carotid.net - Christian PETITJEAN, MD - General Public Area -