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When plaque from atherosclerosis builds up in the carotid arteries, which are the big blood vessels in the neck that carry blood to the brain, the condition is called carotid artery disease (CAD). This constriction, known as stenosis, slows blood flow and raises the risk of stroke. It is responsible for 10–15% of ischaemic strokes. It usually doesn't show any symptoms at first, but it can happen to those over 65, especially if they smoke, have high blood pressure, diabetes, or high cholesterol.
This picture shows where the carotid arteries are and how plaque formation can cut off blood flow to the brain.

Signs and Dangers

Early CAD doesn't usually create symptoms, but in extreme situations, it can seem like a stroke or transient ischaemic attack (TIA): abrupt paralysis in the face or limbs, trouble speaking, visual loss, dizziness, or a severe headache. Plaque breaks or blood clots can block blood vessels in the brain, which can cause death or disability. The risk goes up with age and heart health.
Diagnosis
Doctors use ultrasound to check for stenosis and CT/MRI angiography to get a better look at plaques. Carotid duplex scans find more than 70% narrowing that needs treatment.

Choices for Treatment

For mild cases, the best medical treatment is to take antiplatelets like aspirin, statins for cholesterol, and blood pressure control and make lifestyle changes like quitting smoking, eating better, and getting more exercise. Severe symptomatic stenosis (>70%) may necessitate carotid endarterectomy or stenting to re-establish blood flow and avert stroke. Monitoring regularly is important.