An individual with carotid occlusive disease may have no symptoms at all until he or she experiences a transient ischemic attack (TIA) or a full-blown stroke. But there are warning signs and risk factors that indicate someone may have or be developing carotid occlusive disease:
- High cholesterol levels, especially high “bad” cholesterol (LDL)
- High blood pressure
- High levels of homocysteine in the blood
- Diabetes
- Smoking
- Obesity
- Family history of stroke
A primary care physician may detect abnormal blood flow in the neck that indicates the possibility of carotid stenosis — a vigilant physician will be especially mindful of the risk factors above when listening to a patient’s carotid blood flow. This turbulent sound, called a “bruit,” may be heard through a stethoscope during a routine examination. If the physician hears a bruit, the patient is usually referred for ultrasound imaging of the carotid arteries.
If carotid occlusive disease is not detected during a routine exam, it may reveal itself with a neurological episode called a transient ischemic attack, or TIA, often referred to as a "mini-stroke." Symptoms of a TIA may include:
- Weakness, tingling, or paralysis on one side of the body
- Slurred speech or difficulty speaking
- Confusion
- Vision disturbances, eye pain, or loss of vision in one eye
- Dizziness, or difficulty maintaining balance
- Severe headache
These symptoms are usually short-lived, resolving themselves within a few hours. They should not be ignored, however, as they are often an indicator of advancing carotid stenosis and are a major risk factor for a future stroke.
Symptoms of a full-blown stroke are similar to those of a TIA, but are more severe and longer in duration (not resolving within 24 hours). A stroke is not always caused by carotid occlusive disease, but often is.
Find out more about the Stroke Program at the Weill Cornell Brain and Spine Center.
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Reviewed by Y. Pierre Gobin, M.D.
Last Reviewed/Updated: September 2020
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