2017/ 2018/2019 all brain & cervical mra follow up on aneruysm all good. dec 21 mra now shows moderate stenosis in carotid arteries cervical spine how can this happen so fast? not a smoker 8st good diet excercise?

You could ask a radiologist to review the prior studies to determine whether there was some carotid stenosis in those studies. It is felt by some experts that mild stenosis progresses slowly while stenosis of 50 % or more progresses more rapidly. I recommend consulting a vascular surgeon to determine how best to follow-up your carotid stenosis.

Carotid stenosis, in absence of dissection proceeds slowly over years. Key is the percent of closure, and if above 50-60%, decisions need to be made regarding aggressive intervention. However, most of these stenoses can be managed with medication, such as anti platelet items. Risk factors such as hypertension, hyperlipidemia, elevated homocysteine, diabetes, smoking, need to be addressed.