Neck Artery Issues: Risks, Symptoms, and Management

Neck issues

Hello Doctor, I experienced sudden unilateral tinnitus in April, which led me to consult an otolaryngologist.
My hearing test results were normal.
Then one day, I suddenly experienced vertigo and sought medical attention again from the otolaryngologist.
The doctor examined me and mentioned that my tinnitus and dizziness did not seem to be caused by an ear issue, so I was referred to a neurologist.
The neurologist conducted two tests: a dynamic posturography and a cranial ultrasound.
I also paid out of pocket for an MRI of the brain.
The reports indicated no abnormalities or tumors in the brain.
The dynamic posturography showed that I would feel more dizzy when I closed my eyes, and the cranial ultrasound revealed mild sclerosis in the left carotid artery, but it was deemed not serious.
The doctor advised me to reduce my intake of fatty foods and to exercise.
He mentioned that sclerosis typically appears around the age of 50, which he said was too early for my age.
After returning home, I researched online and found that issues with the carotid artery can be quite dangerous.
At the time, I didn’t ask the doctor many questions, but now I understand the potential life-threatening risks, which has made me anxious and fearful.
I would like to ask the doctor: when the doctor mentioned mild sclerosis, does that mean there is no immediate danger? I read online that there are medications that can help control and prevent further sclerosis; why didn’t the doctor mention this? Is mild sclerosis equivalent to atherosclerosis? Does atherosclerosis pose a risk of plaque rupture leading to thrombosis or cerebral embolism? Are there any foods that can help reverse or eliminate sclerosis?
Additionally, my tinnitus has not stopped, and since I have already undergone an MRI, can I be reassured that there are no brain issues causing it? The otolaryngologist has not provided further treatment for my tinnitus; does this mean it cannot be treated? Does this imply that tinnitus is not caused by a serious illness? I have seen some cholesterol-lowering health supplements online; would they be beneficial for me? (For example: red yeast rice, maitake mushrooms, fish oil, etc.)
Now that I know about the carotid artery sclerosis, is there a need for further testing or any specific tests to better understand the degree of sclerosis? I apologize for the numerous questions, and I would greatly appreciate your assistance or suggestions on how to proceed.
Thank you.
I am also concerned about my family, especially since my youngest child is not yet three years old.
I fear suddenly falling ill or having a serious condition that would prevent me from caring for my child.
I am genuinely worried and scared.
Thank you for your help.
I believe I do not have hypertension, diabetes, or hyperlipidemia; my height is 153 cm, and my weight is 63 kg.

Miss Yang, 40~49 year old female. Ask Date: 2021/07/16

Dr. Jiang Junyi reply Neurology

Dear Ms.
Yang,
If you are concerned about vascular aging, it is advisable to have a clear understanding of your condition regarding the three highs (hypertension, hyperglycemia, and hyperlipidemia).

For blood pressure measurement: In the population around 50 years old, systolic blood pressure should be between 110-140 mmHg and diastolic blood pressure between 70-90 mmHg.
Fluctuations within approximately 10-15 mmHg of the ideal blood pressure (120/80 mmHg) are generally acceptable.
However, if you have conditions such as proteinuria or diabetes, stricter control is necessary.
For fasting blood glucose and glycated hemoglobin (HbA1c) measurement: The average lifespan of red blood cells is about 120 days, so measuring the percentage of glycated hemoglobin in the blood can reflect blood glucose control over the past three months.
For lipid profile measurement: It is generally considered that an LDL-C level exceeding 130 mg/dl or an LDL-C/HDL-C ratio greater than 3.5 indicates a high risk for cardiovascular diseases (such as coronary artery disease and stroke).
Thank you for your inquiry.
If you have any related questions, feel free to discuss further!
Wishing you good health, peace, and joy.
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2021/07/16

More Info

Understanding neck artery issues, particularly carotid artery health, is crucial for preventing serious complications such as stroke. Based on your description, it seems you have experienced a series of concerning symptoms, including unilateral tinnitus (ear ringing) and dizziness, which led you to seek medical attention. The subsequent evaluations, including MRI and ultrasound, revealed mild carotid artery hardening but no significant abnormalities in the brain.

Carotid Artery Hardening and Its Implications
Carotid artery hardening, also known as carotid artery stenosis, is often a result of atherosclerosis, where plaque builds up in the artery walls. This condition can lead to reduced blood flow to the brain and increase the risk of stroke. The fact that your doctor described the hardening as "mild" is reassuring, as it suggests that you are not currently at immediate risk for severe complications. However, it is essential to monitor this condition closely, especially given your age and symptoms.

Risks and Symptoms
While mild hardening may not pose an immediate threat, it is important to understand that atherosclerosis can progress. Symptoms of significant carotid artery disease may include:
- Sudden weakness or numbness in the face, arm, or leg, especially on one side of the body.

- Difficulty speaking or understanding speech.

- Sudden vision problems in one or both eyes.

- Dizziness or loss of balance.

If you experience any of these symptoms, it is crucial to seek emergency medical attention.

Management and Lifestyle Changes
Your doctor’s advice to reduce fatty foods and increase physical activity is a standard recommendation for managing carotid artery health. Lifestyle changes can significantly impact the progression of atherosclerosis. Here are some strategies:
1. Diet: Focus on a heart-healthy diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats (like those found in fish and nuts). Foods high in omega-3 fatty acids, such as fish oil, can be beneficial for cardiovascular health.

2. Exercise: Regular physical activity can help improve circulation and reduce cholesterol levels. Aim for at least 150 minutes of moderate aerobic activity each week.

3. Weight Management: Maintaining a healthy weight can help reduce the risk of further arterial hardening.

4. Medication: While your doctor may not have prescribed medication at this time, it is essential to discuss the potential need for cholesterol-lowering medications (like statins) or antiplatelet agents (like aspirin) with your healthcare provider, especially if your risk factors change.

Understanding Ear Symptoms
Regarding your persistent tinnitus, it is essential to note that while it can be associated with vascular issues, it is not always indicative of a severe condition. Tinnitus can arise from various causes, including exposure to loud noises, ear infections, or even stress. Since your MRI did not reveal any abnormalities, it is less likely that your tinnitus is related to a serious brain issue. However, if it persists or worsens, further evaluation by an ear, nose, and throat (ENT) specialist may be warranted.

Further Investigations
If you are concerned about the degree of carotid artery hardening, you might consider discussing additional tests with your doctor, such as:
- Carotid Doppler Ultrasound: This non-invasive test can provide more detailed information about blood flow and the degree of stenosis.

- CT Angiography or MR Angiography: These imaging techniques can give a clearer picture of the arteries and help assess the extent of any blockages.

Conclusion
Your concerns about your health and the impact on your family are completely understandable. It is essential to maintain open communication with your healthcare providers, ask questions, and seek clarification on any issues that concern you. Regular follow-ups and adherence to lifestyle changes can significantly mitigate risks associated with carotid artery hardening. Remember, early detection and proactive management are key to maintaining your health and well-being.

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