Teaching NeuroImage: Carotid Web: A Thrombogenic Nest Not to Miss. (15th March 2022)

• Record Type: Journal Article
• Authors: Rafailidis, Vasileios; Koutroulou, Ioanna; Psoma, Elizabeth; Kouskouras, Konstantinos; Alexandratou, Maria; Stoiloudis, Panagiotis; Prassopoulos, Panos; Grigoriadis, Nikolaos; Karapanayiotides, Theodoros
• Is Part Of: Neurology. Volume 98:Number 11(2022)
• Page Start: 466
• Page End: 467
• Publication Date: 2022-03-15
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000013321
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : A 61-year-old woman suffered a territorial infarction because of right middle cerebral artery occlusion. CT angiography and ultrasonography showed an ipsilateral carotid web with a small superimposed thrombus (Figures 1 and 2). After 2 weeks on enoxaparin and aspirin, the thrombus resolved completely and the patient underwent uncomplicated carotid stenting, in the absence of other stroke causes. Carotid web, an intimal variant of fibromuscular dysplasia, is an underestimated cause of cryptogenic stroke, notorious for being missed or taken for atheroma by ultrasonography. 1 It may have a high rate of stroke recurrence under antiplatelets owing to thrombus nesting along its blood-stagnation-causing downstream surface. 2