- Short-term memory loss
- Dizziness (vertigo)
- Headache
- Ringing in the ears
- Depression
- Blurred vision
The diagnosis is confirmed by analyzing
the blood flow to the brain based on ultrasound exam.
Cerebral vascular insufficiency is an extremely
common condition in the elderly of developed countries due to the
high prevalence of atherosclerosis (hardening of the arteries).
The artery affected in most cases is the carotid artery. These paired
arteries - one on each side of the neck running parallel to the
jugular vein - are the main arteries that supplies brain. Most often
the problem develops at the carotid bifurcation - the splitting
of the carotid artery into the internal (supplying the brain) and
external (supplying the face and scalp) branches. This bifurcation
is similar to a stream splitting into two branches. At the bifurcation,
just like the splitting of the stream, debris and sediment accumulates.
Significant symptoms begin to appear in most cases only when the
blockage of the artery has reached 90%.
Severe disruption of blood and oxygen supply
results in a stroke. The official definition of a stroke is loss
of nerve function for at least 24 hours due to lack of oxygen. Some
strokes are quite mild, others can leave a person paralyzed, in
a coma, or unable to talk depending upon which part of the brain
is affected. Smaller "mini-strokes" or transient ischemic attacks
(TIAs) may result in loss of nerve function for an hour or more,
but less than 24 hours. TIAs may produce transient symptoms of cerebral
vascular insufficiency - dizziness, ringing in the ears, blurred
vision, confusion, etc.
The obvious treatment goal is to increase
the amount of blood and oxygen to the brain, but I do not know if
surgery is the best answer in your case. The surgery known as "carotid
endarterectomy" involves the surgical removal of the atherosclerotic
plaque from the carotid artery. This surgical procedure is highly
controversial as approximately 6% to 10% of the patients will either
die or suffer severe neurological damage as a result of a stroke
during the surgery. All in all approximately 7% to 11% of the patients
will die during or soon after (less than one month) after carotid
endartectomy. Most of these patients are dying in vain. Like coronary
bypass, the majority of patients having carotid endarterectomy do
not need it. Detailed analyses published in the New England Journal
of Medicine showed that at best only 35% of the people having this
surgery really need it. Carotid endarterectomies are of no value
in people with less than 70% blockage. Performing the surgery on
arteries that have less than 70% blockage is simply not worth the
risk. The risk is simply too great as approximately 9.8% of the
patients undergoing carotid endarterectomy will die of a stroke
within 30 days of the operation or suffer permanent neurological
damage.
Despite the lack of benefit in most cases,
approximately 100,000 carotid endarterectomies are performed each
year in the United States. At a cost of roughly $25,000 per procedure,
that is a total of over $2.5 billion dollars each year.
If you have symptoms of severe cerebral
vascular insufficiency including frequent TIAs or a past stroke
along with severe (greater than 70% blockage of the carotid artery)
then carotid endartectomy may be appropriate. However, before electing
to go ahead with this surgery, I recommend that you consult a qualified
EDTA chelation specialist. EDTA chelation involves the intravenous
administration of EDTA - a compound which pulls out plaque components
and helps breakdown the plaque. Contact the American College of
Advancement in Medicine (ACAM), 23121 Verdugo Drive, Suite 204,
Laguna Hills, CA, 92653, 1-800 532-3688 (outside California) or
1-800-435-6199 (inside California).
Ginkgo biloba
extract (GBE) has displayed a statistically significant regression
of the major symptoms of cerebral vascular insufficiency and impaired
mental performance, in well-designed studies. In fact, the quality of research on GBE is comparable
to FDA-approved drugs. The dosage for GBE (24% ginkgo flavonglycosides)
is 240-320 mg three times daily.
