Screening is recommended for people who have:
Vascular disease elsewhere in the body, including:
Peripheral artery disease (PAD)
Coronary artery disease (CAD)
Atherosclerotic aortic aneurysm (AAA)
Two or more of the following risk factors:
High blood pressure (hypertension)
High cholesterol (hyperlipidemia)
Tobacco smoking
Family history – First-degree relative diagnosed with atherosclerosis before age 60 or who had an ischemic strokeThe American Heart Association also recommends screening if a physician detects a carotid bruit, or murmur, over the carotid artery by listening through a stethoscope during a physical exam. For people with symptoms, the American Heart Association recommends initial screening using ultrasound. Treatment
The goal of treating carotid artery stenosis is to reduce the risk of stroke. The type of treatment depends on the severity of the disease and includes:
Lifestyle modifications including smoking cessation, eating a healthy diet and reducing sodium intake, losing weight, and exercising regularly. Medications to control high blood pressure and high levels of lipids in the blood. Surgical intervention for carotid artery revascularization. Medication
Clinical guidelines (such as those of the American Heart Association (AHA) and National Institute for Clinical Excellence (NICE)) recommend that all patients with carotid stenosis be given medications to control their vascular risk factors, usually blood pressure lowering medications (if they have hypertension), diabetes medication (if they have diabetes), and recommend exercise, weight reduction (if overweight) and smoking cessation (for smokers). In addition, they would benefit from anti-platelet medications (such as aspirin or clopidogrel) and cholesterol lowering medication (such as statins, which were originally prescribed for their cholesterol-lowering effects but were also found to reduce inflammation and stabilize plaque).
Intracerebral hemorrhage (ICH), also known as cerebral bleed, intraparenchymal bleed, and hemorrhagic stroke, or haemorrhagic stroke, is a sudden bleeding into the tissues of the brain, into its ventricles, or into both. It is one kind of bleeding within the skull and one kind of stroke. Symptoms can include headache, one-sided weakness, vomiting, seizures, decreased level of consciousness, and neck stiffness. Often, symptoms get worse over time. Fever is also common.Causes include brain trauma, aneurysms, arteriovenous malformations, and brain tumors. The biggest risk factors for spontaneous bleeding are high blood pressure and amyloidosis. Other risk factors include alcoholism, low cholesterol, blood thinners, and cocaine use. Diagnosis is typically by CT scan. Other conditions that may present similarly include ischemic stroke.Treatment should typically be carried out in an intensive care unit. Guidelines recommend decreasing the blood pressure to a systolic of 140 mmHg. Blood thinners should be reversed if possible and blood sugar kept in the normal range. Surgery to place a ventricular drain may be used to treat hydrocephalus, but corticosteroids should not be used. Surgery to remove the blood is useful in certain cases.Cerebral bleeding affects about 2.5 per 10,000 people each year. It occurs more often in males and older people. About 44% of those affected die within a month. A good outcome occurs in about 20% of those affected. Intracerebral hemorrhage, a type of hemorrhagic stroke, was first distinguished from ischemic strokes due to insufficient blood flow, so called "leaks and plugs", in 1823.