Care at Milton S. Hershey Medical Center

Cerebrovascular disease is also known as carotid artery disease. It develops when arteriosclerosis (fatty) deposits or fatty plaque causes the carotid arteries in your neck to narrow. This prevents blood from flowing through the artery easily. Studies have shown that when carotid arteries become narrow, it raises your chances of having a stroke.

Treatments to open narrow arteries and prevent stroke

If cerebrovascular disease causes major narrowing of your carotid artery, our neurosurgeons may need to open up the artery. Here’s how our experts can do that:

Carotid endarterectomy

Carotid endarterectomy is done to open or clean out your carotid artery. It’s the most common surgery we do to keep our patients from having a stroke. Our neurosurgeons at Penn State Hershey Medical Center are well trained in doing this surgery.

  • Most of the time, it’s done when you’re under regional anesthesia. This is when we keep you comfortable by giving you a shot to numb the area that will be operated on.
  • Since you’ll be awake, you’re not as likely to have side effects to your heart or lungs from the anesthesia. You’ll also recover faster.
  • Most patients leave the hospital the next day.

Carotid angioplasty and stenting (CAS)

Carotid angioplasty uses a balloon and a stent (a hollow tube of wire-like mesh) to open a narrow carotid artery from inside your blood vessel.

  • Your surgeon inserts a flexible tube called a catheter into a large artery in your groin area (the femoral artery). This is done through a small, quarter-inch cut in your skin. 
  • Your surgeon guides the catheter up to the carotid artery in your neck. He or she passes a balloon through the catheter to the blocked part of your artery. 
  • Your surgeon inflates the balloon to open up the blockage. 
  • After the blockage is open, your surgeon places a stent across the area of narrowing to keep your artery wide open. 
  • The surgery is done while you’re awake. Most patients go home the next day.

Groups, Classes & Support

Support groups provide an opportunity to share your feelings and connect with other parents and caregivers who are experiencing similar struggles.

Learn more about support groups offered at Penn State Health Milton S. Hershey Medical Center

Research & Clinical Trials

The Department of Neurosurgery at Penn State Health Milton S. Hershey Medical Center has a strong and active research program in stroke and cerebrovascular disease. The department’s scientists are known worldwide and are working on the answers to a range of research questions that include:

  • How to provide quality of life for stroke patients and their families
  • Understanding basic cellular activities involved in cerebrovascular (carotid artery) disease
  • Creating exciting new therapies to help the brain repair itself after a hemorrhage (major blood loss) or infarction (when blood can’t get to the brain and causes brain tissue to die)

Advancing research in cerebrovascular disease

Penn State Health is involved in a wide number of clinical and laboratory projects that will help improve care for stroke patients. These projects will also help develop new therapies for this challenging disease. Our research includes:

  • ATTACH trial. We are trying to learn how tight blood pressure control can treat intracerebral hemorrhage – a type of stroke caused by bleeding within the brain tissue itself.
  • CLEAR III trial. We studied the role of tPA (an enzyme that helps dissolve blood clots) in treating intraventricular hemorrhage – bleeding into the fluid-filled areas inside the brain.
  • Pipeline Embolization Device database. This database is combined with data from a number of centers around the U.S. to learn which patients are helped the most from a new device that treats aneurysm (a bulge in a blood vessel in the brain).
  • Stenting studies. Penn State Hershey neurosurgeons are learning more about how stenting can treat brain aneurysms and intracranial occlusive disease, which causes a type of stroke.
  • Laboratory studies. We’re studying two kinds of strokes – ischemic stroke (when a blood vessel in the brain is blocked by a blood clot) and hemorrhagic stroke (when a weak blood vessel ruptures).
  • Radiosurgery studies. We are learning how a single, focused, high dose of radiation can be used to treat brain aneurysms.
  • Retrovirus studies. We’re studying how retroviruses (a virus that comes with its own special enzyme) can encourage brain cells to make new brain tissue after a stroke.

To learn more about current clinical trials, visit StudyFinder

Symptoms, Diagnosis & Outlook

Symptoms of carotid artery disease

In the early stages of the disease, you may not have any symptoms. After plaque builds up, the first symptoms of carotid artery disease may be a stroke or a transient ischemic attack (TIA). A TIA is a small stroke that doesn't cause any lasting damage.

Symptoms of stroke and TIA include:

  • Blurred vision
  • Confusion
  • Memory loss
  • Loss of feeling in parts of your body
  • Problems with speech and language
  • Vision loss
  • Weakness in one part of your body

Exams and tests

Your doctor will give you a physical exam and may use a stethoscope to listen to the blood flow in your neck for an unusual sound called a bruit. This sound may be a sign of carotid artery disease.

Your doctor also may find clots in the blood vessels of your eye. If you have had a stroke or TIA, a nervous system (neurological) exam will show other problems.

You may also have the following tests:

The following imaging tests may be used to check the blood vessels in your neck and brain:

Outlook for patients with carotid artery disease

  • Because there are no symptoms, you may not know you have carotid artery disease until you have a stroke or TIA.
  • Stroke is a leading cause of death in the United States.
  • Some people who have a stroke recover most or all of their functions.
  • Others die of the stroke itself or from complications.
  • About half of people who have a stroke have long-term problems.

Possible complications

Two major health problems that may happen because of carotid artery disease are:

  • Transient ischemic attack (TIA). This is when a blood clot briefly blocks a blood vessel to the brain. It causes the same symptoms as stroke. Symptoms last only a few minutes to an hour or two, but no longer than 24 hours. A TIA does not cause lasting damage. TIAs are a warning sign that a stroke may happen in the future if nothing is done to prevent it.
  • Stroke. When the brain’s blood supply is partly or totally blocked, it causes a stroke. Most often, this happens when a blood clot blocks a blood vessel to the brain. A stroke can also happen when a blood vessel breaks open or leaks. Strokes can cause long-term brain damage or death.

We can help

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