The left common carotid artery derives directly from the aortic arch, while the right artery originates from the innominate (or anonymous) artery.
Anatomically, each carotid artery is distinguishable in:
- Common carotid;
- Internal carotid artery;
- External carotid.
The common carotid arteries rise deeply in the neck and divide at the level of the larynx (Adam's apple) into an external and an internal carotid artery.
The carotid sinus, located at the base of the internal carotid artery,
- The external carotid arteries supply the following structures: neck, pharynx, esophagus, larynx, jaw, scalp and face.
- The internal carotid arteries, on the other hand, enter the skull at the level of the carotid holes of the temporal bones, bringing blood to the brain. From here they go up to the level of the optic nerve, where they are divided into three branches: ophthalmic artery (vascularises the eye) , anterior cerebral artery (supplies the frontal and parietal lobes of the brain) and middle cerebral artery (supplies blood to the midbrain and lateral structures of the cerebral hemispheres).
The brain is extremely sensitive to changes in the vascular supply, so much so that an interruption of circulation for a few seconds will produce unconsciousness, while after about four minutes the brain damage will be permanent. These circulatory crises are rare, since the blood can reach the " brain also through the vertebral arteries.
The internal carotids generally supply blood to the anterior half of the brain, while the rest of the brain receives blood from the vertebral arteries. However, this distribution can change easily: the internal carotid arteries and a portion of the vertebral artery (ie the basilar artery) are interconnected by the circle of the Willis, a ring-shaped anastomotic circuit that surrounds the pituitary. Thanks to this cerebral arterial circulation, the possibility of a serious interruption of the vascular supply to the brain is reduced.
smooth. Following a process called atherosclerosis, their walls can however undergo a progressive stiffening accompanied by the reduction of the internal lumen; this phenomenon is caused by the gradual accumulation of deposits (atheromatous plaques) made up of fats, proteins, fibrous tissue and other cellular debris. Over time, these plaques can form a large mass that reduces the internal diameter of the artery, limiting blood flow (called carotid stenosis). Atheromatous deposits form mainly in the carotid sinus, ie at the level of the bifurcation that divides the " common carotid artery in internal and external carotid artery.Obstructive carotid artery disease develops slowly and often goes unnoticed: the first indication of the presence of atheroma can already be very serious, such as the appearance of a cerebral stroke or a transient ischemic attack (TIA).
Treatment of carotid stenosis aims to reduce the risk of significantly reducing the blood supply to the brain by removing atheromatous plaque and controlling blood clotting (to prevent thromboembolic stroke).
or symptom. The stricture may only become evident when it becomes severe enough to deprive the brain of blood, leading to a stroke or transient ischemic attack (TIA), both of which are early warning signs of a future stroke.Signs and symptoms of a transient ischemic attack or stroke can include:
- Sudden numbness of the face or weakness of the limbs, often on only one side of the body
- Inability to move one or more limbs;
- Difficulty speaking and understanding;
- Sudden difficulty in vision, in one or both eyes
- Vertigo and loss of balance
- A sudden, severe headache with no known cause.
Even if the signs and symptoms last only a short time (sometimes less than an hour) it is possible that the patient has experienced a TIA. If any of these manifestations occur it is important to seek emergency care, to increase the chances that carotid artery disease is identified and treated promptly, before a disabling stroke occurs. It is not excluded that a TIA may be due to a lack of blood flow in other vessels as well: the doctor is able to determine which tests are necessary to ascertain the condition.
