Nothing good, is the answer

November 20, 2009 6:37 PM

What does it mean to say that someone "had tests run and that the two arteries to her head are in bad shape with one being closed and the other partly closed"?

This is in regards to my great-great-aunt, who is 95, and has declined surgery. (There is no trauma to her head that I am aware of, although she had a bad fall recently.) That's a third-hand account at least of what the doctor said.

She's a good, strong lady and it's going to be tough on my folks when she goes. I'd like to know (without needling them at a difficult time) if I need to expect that right away. A Google search is not much good with that text string, though.

posted by Countess Elena to health & fitness (7 comments total)

I have no idea if this is what your aunt is suffering from, but it is a somewhat common occurrence with old age, Carotid Stenosis.
posted by 517 at 7:11 PM on November 20, 2009

IANAD (nor do I play one on TV or the internet). However, she may mean she has carotid artery disease, which would mean she's at a high(er) risk of stroke. Hopefully a MefiMed will chime in and correct me if I'm wrong, or add to this if I'm not.

Best of luck to your g-g-aunt.
posted by dilettante at 7:12 PM on November 20, 2009

Here's what an emergency room doctor had to say:

Although the diagnosis sounds pretty bad at first, the slow accumulation of blockage can be compensated for somewhat by the other arteries to the head (e.g., the vertebral arteries). The completely blocked artery is, unfortunately, basically irreparable. The partly blocked artery could be amenable to surgery, but in many cases, especially with a patient as elderly as your great-great-aunt, it would not be an error to recommend against surgery as there is a substantial risk of severe complications (e.g., causing a stroke). Declining surgery was probably a wise decision on her part. In blunt terms, she may live for a considerable while yet, though not in an ideal state.

Of course, this is based only on the information given and is a generalization. There could be any number of complicating factors that would change her prognosis.

You and your family have my sympathies.
posted by jedicus at 7:33 PM on November 20, 2009

probably echoing mostly what other posters have said, but still.. also not a doctor, but it seems to me that many older folks may actually have blocked arteries than are diagnosed. it is a common consequence of our lifestyle (esp diet) that arteries and other vessels progressively narrow during our lifetime, so it is not shocking that a 95 yr old would have blockage. These blockages can be detected sometimes very easily when they are very severe, i.e. when they cause a stroke or pulse weakening in a major artery, but in many case they are undetected until death...sometimes when death is caused by other reasons. the detail that your gg aunt had a fall makes me think that some sort of analysis or scan of her head might have been done and these blockages found without specifically searching... otherwise, maybe they would not have been detected for a while.

a doctor would have much more precise risk factors maybe of things here, but my general take on it is that even if this is something that would be severe and an emergency for a 50 yr old, she is 95 yrs. old and her age makes surgery more dangerous than the severity of pretty much any problem that would require such major surgery to fix.

my understanding of these things is similar to other posters, that progression is uncertain, that other vessels compensate somewhat...so maybe you really don't need to worry anymore than you might worry about a 95 yr old woman anyway. Best of luck..nice to hear of such a caring family...
posted by Tandem Affinity at 9:24 PM on November 20, 2009

Yeah, echoing the above statements. Technically, a blocked artery in the brain, although somewhat a big deal and scary-sounding, doesn't have to be that bad all by itself. At least it's not for me :) I've got one in the left side of my brain, diagnosed at 28. After many, many tests its been shown I have adequate-to-good blood flow in my brain, thanks to other arteries compensating, and other smaller vessels growing to get around the blockage. (I've seen the pictures from my angiogram -- it's actually pretty amazing how the body compensates.) Of course, I'm not a doctor, and your gg-aunt's MMV, but after 6 months of TIAs (mini-strokes and the symptom that got me to a neuro) the symptoms just went away on their own and now I'm totally fine :) Best of luck to you and your family.
posted by cgg at 9:45 PM on November 20, 2009

Thanks for the good words, y'all -- I really appreciate it.
posted by Countess Elena at 6:33 AM on November 21, 2009

IANAD, but my dad had 100% and 84% (or some number in the 80s) occlusion in his left and right carotid arteries, culminating in a TIA and an episode of passing out. Subsequently his doctors put him on Coumadin, he had stents put in, stopped smoking, changed his diet and hasn't had any further issues since. The biggest difference is that he was in his mid-50s at the time and thus better able to tolerate the surgery for the stent.
posted by squorch at 11:34 AM on November 21, 2009