Occlusive Disease

Occlusive disease is the obstruction or blockage of the body's blood vessels. Neurosurgeons typically see patients who have occlusive disease that affects the arteries in the head and neck, such as the carotid, vertebral, basilar, and cerebral arteries.

WHAT ARE THE SYMPTOMS?

The most common symptom of occlusive disease is a transient ischemic attack (TIA), or "mini stroke." Symptoms of a TIA may include weakness, tingling, or numbness on one side of the body, partial vision loss, and the inability to speak clearly. All of these symptoms usually clear up within minutes, but always within 24 hours after they begin, and leave no residual effects. If symptoms do not clear within minutes, the patient should be taken to a hospital immediately, preferably to a stroke center.

If these same symptoms persist for longer than 1 hour, they may indicate that the affected artery has become totally blocked and blood flow to the brain is completely cut off. This can lead to a full-blown stroke, which requires immediate medical attention.

Other symptoms of occlusive disease are less common and vary depending on which arteries in the head and neck are affected. In general, however, symptoms may include:

Visual disturbances;
Weakness or numbness in the limbs or face;
Speech difficulties (aphasia);
Dizziness; and
Cognitive problems, such as memory loss.

CAUSES AND RISK FACTORS

Occlusive disease occurs when plaque (a substance made in part of cholesterol and calcium) accumulates in a person's blood vessels, a process called atherosclerosis, or hardening of the arteries.

Occlusive disease commonly affects the carotid arteries, which bring blood from the heart to the head via the neck. Other arteries that may be affected include the:

Vertebral arteries;
The basilar artery; and
Cerebral arteries.

Factors that put people at risk for atherosclerosis also put them at risk for occlusive disease. These include:

Smoking;
Hypertension;
A diet high in fat and cholesterol;
Diabetes; and
A family history of atherosclerosis.

DIAGNOSIS

Physicians first perform a thorough medical history and physical examination of the patient, but will also use other tests to confirm a diagnosis of occlusive disease, such as:

Computed tomography (CT) scan;
Magnetic resonance imaging (MRI);
Duplex ultrasonography;
Angiography; and
Magnetic resonance angiography (MRA).

TREATMENT APPROACH

Treatment of occlusive disease aims to remove the blockage from the affected artery so that normal blood flow can be restored and embolization of plaque can be prevented. To do so, the physician may use one of the following procedures:

Endarterectomy;
Angioplasty and stenting; or
Medical therapy using blood thinners and/or other cardiovascular medications.

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