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Intracranial Artery Stenosis

intracranial artery stenosis

Stenosis of the carotid arteries is a narrowing of the lumen of the vessels that are responsible for the blood supply to the brain. Pathology is dangerous and coward: there are no symptoms for a long time, but there can be dangerous complications.

When carrying out diagnostics and treatment, it is necessary to establish the localization of damage, the degree of stenosis, and its causes. Therefore, patients are assigned a wide diagnostic program and treatment methods – today, they are diverse and effectively eliminate the problem.

Most often, the disease affects the extracranial vessels, but the pathology of the intracranial arteries also occurs. This condition is the cause of 50% of the clinical cases of ischemia of the medulla and about 30% of strokes. The doctor must distinguish between complete and incomplete obturation of the vascular lumen, which leads to a violation of the blood supply.

Normally, the common carotid arteries depart the left from the aortic arch and the right from the brachiocephalic trunk. They are directed vertically and located on either side of the cervical spine. Further, there is a division into the external and internal carotid arteries. The branches of the arteries supply blood to the intracranial regions, arteries, parts of the face, organs of the head, and neck.

Why does intracranial artery stenosis develop?

Why does intracranial artery stenosis develop

The disease does not have a single cause. Most often, this is a combination of risk factors. With their prolonged action, sufficient intensity, and the tendency of the organism, the disease develops. This complicates the situation since there is no single factor that needs to be eliminated to correct the situation. Let’s consider the possible reasons:

  1. Atherosclerosis

This is the most common condition that leads to intracranial arterial stenosis and can cause complete interruption of blood flow. Atherosclerosis is a violation of fat metabolism, in which the amount of cholesterol and saturated fatty acids in the blood increases, leading to the formation of plaque on the vessel wall. It interferes with the normal rheological properties of the blood – its flow slows down. The larger the fatty accumulation becomes, the more blood elements accumulate on it, increasing in size. From platelets and red blood cells, which adhere to the site of damage to the wall, a thrombus is formed, which can lead to embolism. Sometimes atherosclerotic formations can become covered with small ulcers, violate the integrity of the vessel, and sometimes block its lumen, stopping the blood flow.

  1. Specific pathology

 Narrowing of the arterial vessel is observed with a disease of the connective tissue that forms the stroma of the intracranial artery; this is called fibromuscular dysplasia – the vessels cease to maintain their tone and collapse, stopping blood flow. Intracranial artery stenosis can accompany some inflammatory diseases of the vascular wall – arteritis, systemic vasculitis, Takayasu’s disease, Horton’s disease. There are rare pathologies, such as moyamoya disease, in which there is a slow, progressive narrowing of the lumen of the arteries.

  1. Hard blow, concussion

 After some traumatic brain injuries, a special hematoma is observed – subintimal, which has an appropriate localization. A thrombus, which forms with increased blood clotting, rare types of anemia, can block the lumen. There is an antiphospholipid syndrome, in which young patients experience heart attacks and strokes precisely because of increased coagulation. Blood clots are formed in case of heart rhythm disturbances while taking certain medications.

  1. Congenital features of the structure of blood vessels – they are tortuous, hypoplastic. Vascular pathology accompanies systemic diseases, diabetes, obesity, and metabolic disorders.

Manifestations and diagnostics of stenosis of the carotid arteries

Diagnostic program for disease

What manifestations are accompanied by pathology?

The clinical manifestations of the disease depend on where the problem is. In the early stages of the disease, compensatory mechanisms are always included. For example, if the blood flow is partially disturbed, a collateral system develops, which will provide alternative pathways for the blood supply to the brain. The lack of oxygen supply is also compensated – pulse and respiration become more frequent, and intracellular processes change; this is sufficient for short-term conditions but not for serious pathology. In such cases, the symptoms develop. With a sharp onset and significant intracranial artery stenosis, compensatory forces do not work, and the clinic has a pronounced character, which indicates a stroke.

  1. One of the first alarms is transient cerebral ischemia. These are short-term episodes of impaired blood supply, which can be compensated for by collateral blood flow.
  2. The condition can be recognized by a decrease in sensitivity and motor activity and experiencing visual disturbances.
  3. At some localizations, corresponding violations occur – speech, hearing, swallowing difficulties, asymmetry of the face, severe pain.
  4. The more common symptoms are dizziness, feeling unwell, weakness, and seizures.
  5. Also, the symptoms of occlusion overlap with the symptoms of the tumor process, dementia; this is indicated by increased irritability, depressive disorders, mood swings, increased sleepiness, decreased memory, and mental abilities.

Diagnostic program for disease

The doctor begins the diagnosis of stenosis of the carotid arteries by interviewing the patient and general clinical research. If there are neurological symptoms, a doctor checks reflexes, sensitivity, physical activity, muscle. Instrumental techniques used include:

  • Ultrasound of stenosis of the carotid arteries of the head and neck with Doppler ultrasound – triplex scanning;
  • Functional tests during ultrasound examination;
  • Computed tomography angiography – visualization of blood flow through the vessels using a contrast agent;
  • Magnetic resonance imaging of the brain.

To diagnose atherosclerosis, a laboratory method is used – the patient donates blood for a blood lipid profile. The pulse and blood pressure are measured accurately. To identify systemic vasculitis, specific laboratory tests and immunological studies are used.

FAQ

  • How is intracranial artery stenosis treated?

The most advanced and least traumatic way of treating carotid stenosis is stenting. Stenting is the placement of a stent, which is a metal tube made of cells, into the narrowed part of the artery.

  • Why is intracranial artery stenosis dangerous?

Damage to the intima of the carotid artery can lead to traumatic occlusion of the vessel and the cessation of blood circulation in its basin – such injuries are assessed as life-threatening and can be fatal.

  • Why is vascular stenosis dangerous?

Arterial stenosis is an extremely dangerous condition that, if untreated, can become a threat to human life. Depending on which artery is blocked, certain vital organs may suffer – the brain, heart, kidneys, lungs, etc.

  • What risks does intracranial artery stenosis surgery take?

Violation of blood circulation in the brain (stroke) with paralysis of the arms and/or legs, speech impairment as consequences of disease and its complications. More often, the reason for this is the detachment of a piece of plaque during manipulations on the carotid artery and getting it into the arteries of the brain, less often the blockage of the carotid artery with blood clots. The risk is very low, at 1-3%.

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Lone Star Neurology
4.4
Based on 617 reviews
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Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been prepared.read more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well together.read more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your business.read more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any cookies.read more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going there.read more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my treatment.read more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to finish.read more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 stars.read more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his staff.read more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best treatment.read more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my doctor.read more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding solutions.read more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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