Bilateral carotid webs

Author:

Essibayi Muhammed Amir1ORCID,Nasr Deena2,Lanzino Giuseppe13

Affiliation:

1. Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA

2. Department of Neurology, Mayo Clinic, Rochester, MN, USA

3. Department of Radiology, Mayo Clinic, Rochester, MN, USA

Abstract

Carotid web is thought to be a focal intimal variant of fibromuscular dysplasia, which comprises a high risk of stroke because of blood stasis and subsequent coagulative reactions that occur distal to the web. These lesions generally involve the posterolateral wall of the carotid and their developmental pathogenesis is controversial. This case report describes a 51-year-old woman who presented to the hospital with sudden onset aphasia, right hemi-sensory loss, and right visual field cut. Magnetic resonance imaging (MRI) of the brain demonstrated a left middle cerebral artery (MCA) distribution embolic ischemic infarct with shelf-like linear filling defects in the carotid bulb bilaterally on a computed tomography angiography (CTA) of the head and neck consistent with bilateral carotid webs that were confirmed by catheter angiography. The carotid webs were projecting on the left posteriorly and on the right anteriorly into the inferior aspects of the bilateral proximal internal carotid arteries. The patient was started on clopidogrel and a high-intensity statin and remained on Plavix monotherapy for a 10-month follow up without a recurrent ischemic event.

Publisher

SAGE Publications

Subject

Clinical Neurology,Radiology Nuclear Medicine and imaging,General Medicine

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